Advancing stomach cancer prevention for high-risk people

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A recent initiative at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine offers new hope in the fight against stomach cancer, particularly among vulnerable populations.

Led by Shria Kumar, M.D., a physician-scientist known for her work with gastric cancer patients, the project targets the eradication of the Helicobacter pylori bacterium, a major risk factor for this severe illness.

In South Florida, where Kumar practices, she often encounters patients whose stomach cancer has advanced significantly by the time they seek treatment, reducing their options and chances for recovery.

This observation sparked her interest in preventive strategies, specifically targeting Helicobacter pylori due to its strong association with gastric cancer.

The team at Sylvester, which included senior author David Goldberg, M.D., and lead research coordinator Damian Cohen, M.D., embarked on a community-based study to screen and treat H. pylori infections in local high-risk groups, such as Black, Asian, and Latino communities.

Their findings, published in Clinical Gastroenterology and Hepatology, demonstrated the feasibility of identifying and treating this infection within community settings.

The researchers used portable breath-test machines at health fairs and community centers, as well as through Sylvester’s Game Changer Vehicles, which are designed to bring cancer screenings directly to underserved populations.

Participants who tested positive for H. pylori were immediately offered free treatment. Of the 52 individuals who initially tested positive, 23 returned for follow-up testing, and nearly all had successfully eliminated the infection.

However, the project faced challenges. Some participants did not complete their treatment, and contact was lost with others.

This highlights the difficulties in ensuring follow-through with treatment protocols, which can be complex and require consistent follow-up.

Despite these hurdles, the results are promising. Screening and treating H. pylori in community settings could significantly reduce the risk of developing gastric cancer, particularly in populations that are disproportionately affected.

Such outreach is crucial in places like Miami, a diverse city with many residents at higher risk due to their ethnic backgrounds or immigration from regions with prevalent H. pylori infection.

The study underscores the potential for broadening H. pylori screening beyond symptomatic individuals, as is common in the U.S., to include routine checks among high-risk groups.

This approach could align more closely with practices in countries like Japan, where regular screening for the bacterium is standard due to its high prevalence and the clear link to stomach cancer.

As the researchers look to future strategies, improving treatment adherence and simplifying the testing process are key objectives.

Advances in medical technology and a deeper understanding of community health dynamics may eventually make routine screening for H. pylori a standard practice in the U.S., much like cholesterol or blood pressure checks.

This research not only offers a blueprint for reducing stomach cancer risk through proactive public health measures but also serves as a call to action for more targeted, community-sensitive health initiatives that address the needs of the most vulnerable among us.

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The research findings can be found in Clinical Gastroenterology and Hepatology.

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