EUROHELICAN—The First Helicobacter Pylori Screen‐and‐Treat Population‐Based Study in Young Adults in Europe

BACKGROUND: Most gastric cancer cases are attributable to chronic Helicobacter pylori (H. pylori) infection and can theoretically be prevented. OBJECTIVE: In the EUROHELICAN project, we aimed to assess the feasibility, acceptability, effectiveness, and adverse events of a Helicobacter pylori screen-and-treat program in the 30-34-year age group for the first time in Europe. DESIGN: The study was conducted in the Community Healthcare Center dr. Adolf Drolc Maribor, following the methodology prepared by the National Institute of Public Health. We invited asymptomatic individuals aged 30-34 to be tested for H. pylori IgG antibodies; positive results were confirmed by urea breath test (UBT). RESULTS: 2102 participants accepted the invitation. The response rate was 24.4% (95% CI: 23.2-25.5), which was higher in women-28.1% (95% CI: 26.4-29.8) than in men-20.5% (95% CI: 0.19.0-22.1, p < 0.001). The serological prevalence of H. pylori infection was 14.2% (95% CI: 12.7-15.9). A confirmatory urea breath test (UBT) was positive in 83.7% of serology-positive patients. The eradication rate of 14-day bismuth-based quadruple therapy (esomeprazole 40 mg BID, amoxicillin 500 mg, metronidazole 400 mg and bismuth oxide 120 mg, all QID) was 94.7% (95% CI: 89.5-97.9). Adverse events (AEs) during treatment were reported more frequently in women (38.8%, 95% CI: 28.1-50.3) than in men (21.5%, 95% CI: 12.3-33.5; p < 0.05). CONCLUSION: H. pylori screening and-treat program in 30-34 age group in Slovenia is feasible; H. pylori treatment is very effective with acceptable rate of AEs. Different approaches to raising public awareness are needed to increase participation rates. TRIAL REGISTRATION: EU PAS number of HMA-EMA RWD Catalog: EUPAS107327, Study ID: 108428; ClinicalTrials.gov ID: NCT06216639, Protocol ID: EUROHELICAN01.