Prevention of gastric cancer: translating pooled cohort evidence into public health action

Gastric cancer is a major global health challenge and a leading cause of cancer mortality. Despite therapeutic advances, most patients do not survive beyond one year. In 2024, the U.S. National Cancer Institute (NCI) Think Tank on Advancing Gastric Cancer Prevention developed a gastric cancer prevention roadmap focussed on mitigating Helicobacter pylori infection and improving detection of precursor lesions. For the vast majority, H. pylori infection is a benign condition which usually remains undiagnosed, and its prevalence has been declining globally; gastric intestinal metaplasia is also a benign condition and only a small fraction of premalignant intestinal metaplasia lesions progress to adenocarcinoma.