Helicobacter pylori eradication improves the prognosis of peptic ulcer disease, dyspepsia, and possibly gastric cancer.
H pylori screening tests are accurate and eradication therapy is effective.
H pylori population screening seems attractive.
Dr Maria Bomme and colleagues from Denmark evaluated the long-term effect of Helicobacter pylori population screening and eradication on dyspepsia prevalence and the incidence of peptic ulcer disease, and as secondary outcomes to assess the effect on health care consumption and quality of life.
At baseline in 1998 to 1999, 20,011 individuals aged 40 to 65 years were randomized to Helicobacter pylori screening and eradication or a control group with no screening.
Both groups received a questionnaire on dyspepsia and quality of life.
|18% were Helicobacter pylori positive|
|Clinical Gastroenterology & Hepatology|
The researchers obtained register data for all randomized individuals.
The baseline questionnaire response rate was 63%.
Of the 5749 individuals screened, the researchers found that 18% were Helicobacter pylori positive.
Complete symptom data were obtained for 69% individuals after 13 years.
Dyspepsia prevalence decreased in both groups during the follow-up period, but multivariate analysis showed no effect of Helicobacter pylori screening and eradication, compared with usual care.
Intention-to-treat and per-protocol analyses of register data provided similar results.
The team found that Helicobacter pylori screening neither reduced peptic ulcer disease incidence significantly nor did it have a beneficial effect on health care consumption.
The researchers observed that Helicobacter pylori screening had no long-term effect on quality of life.
Dr Bomme's team concludes, "This randomized clinical trial with 13 years of follow-up evaluation, designed to provide evidence on the effect of Helicobacter pylori population screening, showed no significant long-term effect when compared with usual care in this low-prevalence area."