01-023 · EVIDENCE A · SOURCE-SENSITIVE
Testing for Helicobacter pylori and eradicating it if positive
查幽门螺杆菌，阳性就根除
The carbon-13 or carbon-14 breath test costs 100 to 200 yuan. Eradicating the bacteria requires taking four different medications for two weeks; the medication cost for that period is 200 to 500 yuan. The main difficulty is ensuring the full two-week course of medication is taken on schedule.
A 22-year follow-up study conducted in Linqu, Shandong, showed that individuals who had Helicobacter pylori eradicated had roughly half the risk of developing gastric cancer and about 40% lower risk of dying from it. Testing costs just 100–200 yuan, while eradication requires a two-week medication regimen.
A
Move “Testing for Helicobacter pylori and eradicating it if positive” to Future Me's calendar
The excuse
One more exception feels free because the bill arrives outside the current scene.
What feels good now
Today I keep a little money, a few minutes, a bit of persistence and avoid interrupting my default routine.
What the source says
The source summarizes the return this way: “A 22-year follow-up study conducted in Linqu, Shandong, showed that individuals who had Helicobacter pylori eradicated had roughly half the risk of developing gastric cancer and about 40% lower risk of dying from it. Testing costs just 100–200 yuan, while eradication requires a two-week medication regimen.” Evidence grade A. The original states the population, caveats, and sources; this is not a personal forecast.
Use the original facts and limits. For an urgent medical, safety, financial, or legal issue, contact a qualified local professional or service.
THE ENGLISH EDITION
Original recommendation and evidence
23. Testing for Helicobacter pylori and eradicating it if positive
Cost: The carbon-13 or carbon-14 breath test costs 100 to 200 yuan. Eradicating the bacteria requires taking four different medications for two weeks; the medication cost for that period is 200 to 500 yuan. The main difficulty is ensuring the full two-week course of medication is taken on schedule.
In plain terms: A 22-year follow-up study conducted in Linqu, Shandong, showed that individuals who had Helicobacter pylori eradicated had roughly half the risk of developing gastric cancer and about 40% lower risk of dying from it. Testing costs just 100–200 yuan, while eradication requires a two-week medication regimen.
Benefit: This randomized trial in Linqu, Shandong, followed participants for 22 years. Those who underwent Helicobacter pylori eradication therapy saw their risk of gastric cancer drop by nearly half. The original odds ratio was 0.48, with a 95% confidence interval ranging from 0.32 to 0.71. Their risk of dying from gastric cancer also fell by roughly 38% (hazard ratio 0.62; 95% CI 0.39–0.99).
Evidence grade: A
Sources: Li WQ et al. (2019). Effects of Helicobacter pylori treatment and vitamin and garlic supplementation on gastric cancer incidence and mortality: follow-up of a randomized intervention trial. BMJ. <https://doi.org/10.1136/bmj.l5016>
Notes: Reinfection can still occur after eradication, so it is advisable for all household members to be tested and treated together. This trial involved residents of an area with a high incidence of gastric cancer; people living in regions with lower incidence may gain considerably less benefit.
Read the complete Chinese source and notes
23. 查幽门螺杆菌，阳性就根除
成本: 碳 13 或碳 14 呼气试验 100 到 200 元。根除要同时吃四种药，两周药费 200 到 500 元。难的地方是这两周的药要按点吃满。
说人话: 山东临朐那项跟踪了 22 年的试验里，把幽门螺杆菌根除掉的人，后来得胃癌的概率低约一半，死于胃癌的概率低约四成。查一次一两百块，根除要吃两周药。
收益: 山东临朐那项随机分组的试验跟踪了 22 年。做过幽门螺杆菌根除治疗的人，得胃癌的风险低约一半。原值 OR 0.48，可信范围 95% CI 0.32 到 0.71。死于胃癌的风险低约 38%（HR 0.62，95% CI 0.39 到 0.99）
证据等级: A
来源: Li WQ 等 (2019). Effects of Helicobacter pylori treatment and vitamin and garlic supplementation on gastric cancer incidence and mortality: follow-up of a randomized intervention trial. BMJ. <https://doi.org/10.1136/bmj.l5016>
备注: 根除以后还可能再感染，所以家里人一起查、一起治。这项试验的人群是胃癌高发区的居民。住在低发区的人，实际拿到的好处会小得多。
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