HHS Classified H. pylori as a Definite Carcinogen

The U.S. Department of Health and Human Services (HHS) released the 15th Report on Carcinogens on December 21, 2021. The Report on Carcinogens is a congressionally mandated, science-based public health document that NTP prepares for the HHS Secretary. This cumulative report now includes 256 listings of substances — chemical, physical, and biological agents, mixtures, and exposure circumstance, among which Helicobacter pylori (H. pylori) is newly added and classified as a definite carcinogen.

ABOUT H. pylori
H. pylori is a small, curved, microaerophilic, gram-negative, rod-shaped bacterium and believed to be mainly fecal–oral or possibly oral–oral transmitted. About two-thirds of the world’s population is infected, but it is more common in developing countries. The rate of H. pylori infection varies greatly in different countries, regions and races, and is closely related to socioeconomic level, population density, public health conditions and water supply.

CLINICAL PRESENTATION
Usually asymptomatic, but H. pylori is the major cause of peptic ulcer disease and gastritis worldwide, which often present as gnawing or burning epigastric pain. Less commonly, symptoms include nausea, vomiting, or loss of appetite. Infected people have a 2-fold to 6-fold increased risk of developing gastric cancer and mucosal associated-lymphoid-type (MALT) lymphoma compared with their uninfected counterparts.

TREATMENT
Since the consequences of H. pylori infection are so serious, can it be cured after infection? The answer is yes. A large number of studies have confirmed that eradication of H. pylori can reverse partial atrophy and intestinal metaplasia, stabilize the disease, and significantly reduce the incidence of gastric cancer. Before the occurrence of atrophy, radical treatment of H. pylori can almost prevent the occurrence of most gastric cancer. The course of H. pylori eradication is generally 7-14 days, and the eradication rate is more than 90%. However, the best therapeutic effect can be achieved only when the medication is administered under the guidance of a doctor.

DIAGNOSIS
Fecal antigen assay, urea breath test, rapid urease test, or histology of biopsy specimen. A positive serology indicates present or past infection.

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