Our goal is to reduce death and suffering from stomach cancer in Texas, especially among minority and low-income populations. In the US, including Texas, rates of advanced stage stomach cancer are increasing among adults aged less than 50. Except for a small proportion of patients who are diagnosed at an early stage, cure is not possible. Therefore, prevention is important.

Helicobacter pylori infection is a bacterial infection of the lining of the stomach that accounts for 90% of stomach cancer cases, and does so by promoting formation of pre-cancerous stomach lesions called intestinal metaplasia and atrophy. Screening for H. pylori infection, which can be done by a blood test, and treatin...

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Our goal is to reduce death and suffering from stomach cancer in Texas, especially among minority and low-income populations. In the US, including Texas, rates of advanced stage stomach cancer are increasing among adults aged less than 50. Except for a small proportion of patients who are diagnosed at an early stage, cure is not possible. Therefore, prevention is important.

Helicobacter pylori infection is a bacterial infection of the lining of the stomach that accounts for 90% of stomach cancer cases, and does so by promoting formation of pre-cancerous stomach lesions called intestinal metaplasia and atrophy. Screening for H. pylori infection, which can be done by a blood test, and treating those infected is known to prevent stomach cancer. Further, reductions in the deaths related to stomach cancer can be achieved through endoscopic screening and surveillance of pre-cancerous stomach lesions.

However, screening for H. pylori and endoscopic surveillance for stomach cancer are not cost-effective in the general US population. Therefore, we need to develop a risk-based approach for H. pylori screening and eradication as well as for screening and surveillance for intestinal metaplasia or atrophy to maximize the value of this two-pronged approach.

We propose to develop an evidence based risk-stratified cost-effective approach for prevention of stomach cancer through screening and treatment for H. pylori and early detection through surveillance of pre-cancerous stomach lesions. We plan to enroll 1,000 residents of Harris County, Texas attending community health centers in Harris Health in the study. This approach ensures oversampling of minority subjects. Our study will provide a detailed understanding of the prevalence and predictors of H. pylori and pre-cancerous stomach lesions in the primary care setting. This information will then be used to estimate cost-effectiveness of screening and surveillance to generate clinical guidelines for stomach cancer control.

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