Helicobacter pylori infection is strongly correlated with peptic ulcer and is a risk factor for gastric cancer.
Doctors in Denmark assessed whether screening and eradication of H. pylori in a general population would reduce the prevalence of dyspepsia and the incidence of peptic ulcer.
The also evaluated the effect of H. pylori eradication on the allocation of healthcare resources and quality of life.
20,000 individuals aged 40 to 65 years were randomized to screening and eradication for H. pylori or to a control group, which was not screened for H. pylori.
H. pylori status was assessed by a blood test, with positive results confirmed by a 13C-urea breath test. Individuals found to be H. pylori positive were offered eradication therapy.
The prevalence of H. pylori infection was 17.5% and the eradication rate was 95%.
The prevalence of dyspepsia decreased slightly from 24.3% before H. pylori screening to 20.5% at 1-year follow-up. In the control group, dyspepsia increased from 20.3% to 21.5%.
| The result of H. pylori screening was not sufficiently extensive to have an effect on the use of health care or to improve quality of life.|
Gastroesophageal reflux symptoms improved slightly in H. pylori eradicated participants.
The screening program did not save healthcare resources. The cost of the screening program outweighed the modest savings made through a reduction in dyspepsia consultations.