Helicobacter pylori eradication and gastric cancer prevention: current evidence and future perspectives.

INTRODUCTION: Helicobacter pylori infection is the principal etiological factor in gastric carcinogenesis that can be prevented through eradication; however, the global burden of gastric cancer (GC) remains substantial. AREAS COVERED: This review summarizes recent and future gastric cancer and H. pylori-induced GC. Relevant literature was identified from PubMed and Scopus, searched between March and April 2026 using specific keywords (Helicobacter pylori eradication OR Gastric cancer prevention), although this was not conducted as a formal systematic review. EXPERT OPINION: Helicobacter pylori remains the main etiological factor for GC, and high atrophic severity in the gastric mucosa is associated with a higher risk of developing GC. As H. pylori eradication can prevent future GC incidence, even in the presence of dysplasia or early GC, a 'screen-and-treat' program with earlier detection and a family-based approach is considered the current best practice for GC prevention. Health policy-making to facilitate access to healthcare, diagnostic tests, and eradication regimens is needed to optimize the population-based 'screen-and-treat' program. Future progress will likely depend on integrating eradication programs with improved risk stratification based on mucosal status, bacterial virulence, and host factors to enable strategies for at-risk populations.