Overview of Gastric Cancer Prevention Initiatives in Europe

Gastric cancer continues to impose a substantial health burden in Europe. The European Council Recommendations have called for consideration of implementing measures aimed at reducing gastric cancer-related mortality.

This manuscript reviews current gastric cancer prevention initiatives in Europe. The GISTAR study in Latvia has been enrolling participants from the general population for Helicobacter pylori screen-and-treat intervention together with serological testing for pepsinogens. The EUROHELICAN study was the first to evaluate an H. pylori screen-and-treat strategy in young adults, which has been expanded within the TOGAS project. In addition, TOGAS has addressed stakeholder perspectives, the cost-effectiveness of screen-and-treat strategies, and the prevalence of gastric precancerous conditions among individuals participating in colorectal cancer screening. The GISTAR cohort has also enabled the assessment of long-term outcomes following H. pylori eradication. The EUGastScreen project, carried out within the EUCanScreen Joint Action, aims to evaluate the feasibility of simultaneous screening for H. pylori infection and colorectal cancer using a stool-based test. The European Registry on H. pylori Management (Hp-EuReg) supports the collection of important clinical data from routine clinical practice. Furthermore, the development of European guidelines for gastric cancer prevention has been initiated as part of the European Commission Initiative on Gastric Cancer and is expected to continue until 2027. The recently published 5th edition of the European Code Against Cancer includes recommendations on H. pylori management for the first time.

Ongoing initiatives will provide important evidence to support the future implementation of gastric cancer prevention strategies, including data on feasibility, acceptability among the general population and stakeholders, and cost-effectiveness. However, additional implementation studies for gastric cancer prevention will be required.