In 1982, two Australian doctors, Dr. Barry Marshall and Dr. Robin Warren, made a major discovery. They found a type of bacteria called Helicobacter pylori, or H. pylori, living in the human stomach.
This was surprising because the stomach is a very acidic place, and it was thought that bacteria couldn’t survive there. But H. pylori can, thanks to its spiral shape and a special enzyme that protects it from stomach acid.
Their discovery changed how doctors think about stomach ulcers and stomach cancer. In fact, the two scientists won the Nobel Prize in Medicine in 2005.
To prove the bacteria’s role in causing ulcers, Dr. Marshall even drank a solution containing H. pylori and developed stomach inflammation. This bold move helped prove the link and led to antibiotics becoming a common treatment for ulcers.
More than 40 years later, researchers in Taiwan wanted to see if testing for H. pylori in stool samples could help predict who is at higher risk for stomach cancer. The study was led by Dr. Yi-Chia Lee at the National Taiwan University College of Medicine and published in the journal JAMA.
Stomach cancer is not as common in Western countries, but it’s still a big problem in parts of Asia like Taiwan and Japan. Globally, stomach cancer caused by H. pylori is the third most common cancer, with around 800,000 new cases each year.
About 90% of these cases are linked to H. pylori, which is considered a Class 1 carcinogen, meaning there is strong proof that it can cause cancer.
In the Taiwan study, over 150,000 people between the ages of 50 and 69 were invited to take part. Some of them were given two tests: one to detect hidden blood in stool (called FIT), and another to detect H. pylori (called HPSA). Others were given only the FIT test.
The idea was to find out if doing both tests could better identify who is at risk for stomach cancer and possibly reduce deaths. FIT is usually used to check for colon cancer, but it can sometimes find stomach cancer too.
H. pylori is tricky to test for because it infects about half of the world’s population. Most people don’t even know they have it, and not everyone who has it will get sick. Things like diet, genes, and the environment also play a role. The bacteria can cause long-term inflammation in the stomach, which can lead to ulcers and cancer.
Doctors often treat H. pylori using a mix of antibiotics and medicines called PPIs that reduce stomach acid. This helps the antibiotics work better. But too much use of antibiotics can lead to resistance, so treatment needs to be done carefully.
The results of the Taiwan study were mixed. The group that had both the H. pylori and FIT tests had a slightly lower rate of stomach cancer, but the number of deaths was about the same as the group that only had the FIT test.
This means that adding the H. pylori test didn’t clearly reduce the number of cancer cases or save more lives. But it did show how complex the problem is. It’s not just about detecting the bacteria, but also understanding how different people respond to it.
Researchers believe that future studies should focus on better ways to screen and on how lifestyle, diet, and ethnic background affect cancer risk. For now, this study reminds us that H. pylori is a major cause of stomach cancer, and managing it properly is key to reducing the disease worldwide.
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