{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T11:43:20Z","timestamp":1792496600113,"version":"4.5.0"},"reference-count":37,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":37,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2026,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Korea has historically borne a high burden of gastric cancer, although substantial epidemiological transitions have occurred over recent decades. Gastric cancer was the most common cancer until 2018, but declined to fifth by 2022. Gastric cancer incidence has decreased steadily, accompanied by marked reductions in mortality and substantial improvements in survival, with 5\u2009year overall survival rate now exceeding 75%. During this period,\n \n Helicobacter pylori<\/jats:italic>\n <\/jats:styled-content>\n (\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n ) seroprevalence has shown a decreasing trend, especially in younger generations.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Randomized controlled trials conducted in high\u2010risk groups have demonstrated that\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n eradication significantly reduces gastric cancer risk. To further evaluate the role of\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n eradication as a primary prevention strategy in the general population, HELPER is currently ongoing in Korea in collaboration with the International Agency for Research on Cancer. For secondary prevention of gastric cancer, the Korean National Cancer Screening Program (KNCSP) was launched in 1999 and provides biennial endoscopic screening for adults aged 40\u2009years or older.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The HELPER study had screened\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n status in >\u200912,000 average\u2010risk Korean participants who had participated in KNCSP up to 2019. Individuals with\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n infection were randomized to receive either bismuth quadruple therapy or placebo. The participants have been followed up through the KNCSP, and an interim analysis is planned after a 6\u2009year follow\u2010up period. Secondary prevention through the KNCSP has achieved high participation rates and is strongly associated with reduced gastric cancer mortality, stage migration to early disease, and increased use of endoscopic treatment.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The current uniform screening strategy does not incorporate individual risk stratification and is costly. Future integration of\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n eradication and objective assessment of gastric atrophy into risk\u2010adapted screening and surveillance strategies may optimize effectiveness, reduce healthcare costs, and further decrease the burden of gastric cancer in Korea.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/hel.70121","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:01:06Z","timestamp":1775624466000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Advancing Gastric Cancer Prevention in Korea: Current Strategies and Future Directions"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2491-5099","authenticated-orcid":false,"given":"Jin Young","family":"Park","sequence":"first","affiliation":[{"name":"International Agency for Research on Cancer (IARC\/WHO), Early Detection, Prevention and Infections Branch Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8339-9824","authenticated-orcid":false,"given":"Il Ju","family":"Choi","sequence":"additional","affiliation":[{"name":"Center for Gastric Cancer National Cancer Center Goyang Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2025.264"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.4178\/epih.e2022051"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.5230\/jgc.2022.22.e36"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.5230\/jgc.2022.22.e21"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.5230\/jgc.2022.22.e22"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0204762"},{"key":"e_1_2_7_8_1","volume-title":"Population\u2010Based Helicobacter pylori Screen\u2010and\u2010Treat Strategies for Gastric Cancer Prevention: Guidance on Implementation","author":"Choi I. 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