# Family-based H. pylori test-and-treat to prevent stomach cancer

Source: https://onco.cc/ideas/idea-prev-hpylori-family-test-and-treat/  
OnCo record `idea-prev-hpylori-family-test-and-treat` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Stomach cancer is largely caused by a bacterium that spreads in households. Testing and treating whole families, not individuals, would stop reinfection and prevent cancer.

## Summary

Mass eradication in Linqu County and the Matsu Islands reduced gastric cancer incidence, and the Chinese family-based consensus recommends household testing. Propose family-unit test-and-treat with stool antigen testing and tailored therapy, evaluated in a cluster-randomised design in high-incidence regions.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Family-based eradication reduces reinfection to under 2% per year and gastric cancer incidence by at least 30% over 15 years versus individual-based treatment.
- Rationale: Household transmission drives reinfection; eradication reduces cancer most in those without established pre-malignant lesions.
- Proposed test: Cluster RCT in 50,000 households with ten-year incidence follow-up.
- Maturity: being-tested-at-scale
- Actor: policy

## Sources

- Bottleneck evidence (Prevention we already have is not deployed): Islami et al., Proportion of cancer attributable to modifiable risk factors (CA 2018): https://doi.org/10.3322/caac.21440

## Connected records

- cancers: [Gastric & gastro-oesophageal junction cancer](https://onco.cc/cancers/gastric/)
- fronts: [Prevention & Risk](https://onco.cc/fronts/prevention/)
- institutions: [Cancer Hospital, Chinese Academy of Medical Sciences](https://onco.cc/institutions/cams-cancer-hospital/)
- bottlenecks: [Prevention we already have is not deployed](https://onco.cc/bottlenecks/b-prevention-adoption/)
- key papers: [Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States](https://onco.cc/key-papers/paper-islami-ca-cancer-j-clin/)
- roadmaps: [Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers](https://onco.cc/roadmaps/prevention-roadmap/)

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