Cancer-Focused Teams
Gastric Cancer Prevention Team (GCP)

Starting date: October 2022

Work Programme

The overall aim of the Gastric Cancer Prevention Team (GCP) is to contribute to reducing the global burden of gastric cancer by producing robust evidence to increase the understanding of its causes and the efficacy and effectiveness of population-based interventions and prevention programmes, and ultimately to implement evidence-based interventions for the prevention and control of gastric cancer and to support their practical application worldwide. GCP aims to achieve its goal through cross-Agency and international collaborations.

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GCP has four main themes and related activities:

• Describing the current and future burden of gastric cancer
  • Understanding the global burden of gastric cancer attributable to Helicobacter pylori infection and the preventable fraction and costs by its eradication
  • Estimating the expected burden of H. pylori-related diseases, focusing on gastric cancer and peptic ulcer diseases in high-risk areas such as China and the Republic of Korea
  • Estimating the impact of various H. pylori test-and-treat scenarios on gastric cancer burden through public health decision modelling

• Understanding risk factors in diverse populations with variable gastric cancer risks using standardized multicentre protocols
  • Investigating the epidemiology of H. pylori infection and co-factors for gastric cancer using standardized methods in areas with low and high incidence of gastric cancer (ENIGMA studies)
  • Investigating blood metabolite signatures for gastric cancer development prospectively using samples taken before diagnosis of gastric cancer, and generating evidence for the role of modifiable risk factors in gastric cancer development (Meta-GC, EPIC collaboration)

• Investigating the role of H. pylori treatment and endoscopic surveillance for gastric cancer prevention in high-incidence areas
  • Effect of H. pylori eradication on gastric cancer prevention in the Republic of Korea: a randomized controlled clinical trial (HELPER, collaboration with the National Cancer Center of the Republic of Korea)
  • Multicentre randomized study of H. pylori eradication and pepsinogen testing for prevention of gastric cancer mortality (GISTAR, collaboration with the University of Latvia)

• Implementation of population-based H. pylori test-and-treat strategies and endoscopic screening in high-risk populations for gastric cancer prevention and reduction in inequalities caused by gastric cancer
  • Demonstration projects in high-risk areas in Europe (EUROHELICAN and TOGAS projects) and elsewhere
  • Hosting an IARC Working Group meeting to develop recommendations on best practices in implementation of H. pylori test-and-treat programmes in various resource settings

Given that the future global burden of gastric cancer is predicted to increase significantly and that this cancer contributes considerably to cancer disparities in many world regions, intense research into gastric cancer etiology and prevention is warranted. GCP’s wide range of activities – from etiological research projects to identify novel biomarkers of metabolic perturbations to randomized controlled clinical trials of primary and secondary prevention and demonstration projects of H. pylori test-and-treat programmes – will provide a comprehensive overview of gastric cancer prevention efforts from IARC and offer further opportunities for new collaborations.

Team Composition

Team Leader: Dr Jin Young Park, Early Detection, Prevention, and Infections Branch (EPR), IARC
Email: parkjy@iarc.who.int

Team members:
Ms Viktoria Knaze (Research Project Associate, EPR)
Dr Gary Clifford (Deputy Branch Head, EPR)
Dr Catherine de Martel (Scientist, EPR)
Dr Iacopo Baussano (Scientist, EPR)
Dr Partha Basu (Branch Head, EPR)
Dr Behnoush Abedi-Ardekani (Scientist, GEM)
Dr Mazda Jenab (Scientist, NME)
Dr Pekka Keski-Rahkonen (Scientist, NME)
Dr Sabina Rinaldi (Deputy Branch Head, NME)
Dr Isabelle Soerjomataram (Deputy Branch Head, CSU)
Dr Eileen Morgan (Scientist, CSU)

Key networks: The international team members span many countries, including networks from HELPER (the Republic of Korea), ENIGMA (the Islamic Republic of Iran, Chile, Uganda, Zambia, and New Zealand), GISTAR (Latvia), EUROHELICAN (Slovenia, Latvia, and France), TOGAS (Latvia, Austria, Belgium, Croatia, France, Germany, Ireland, Lithuania, the Netherlands, Poland, Portugal, Romania, Slovenia, and Spain), and EPIC (France, Italy, Spain, the United Kingdom, the Netherlands, and Germany).

Key funding: French National Cancer Institute (INCa), EU4HEALTH (European Union)

Key publications

1. Sun D, Mülder DT, Li Y, Nieboer D, Park JY, Suh M, et al. (2023). The effect of nationwide organized cancer screening programs on gastric cancer mortality: a synthetic control study. Gastroenterology. S0016-5085(23)05562-2. https://doi.org/10.1053/j.gastro.2023.11.286 PMID:38007053
2. Sjomina O, Vangravs R, Ļeonova E, Poļaka I, Pūpola D, Čivkulis K, et al. (2023). Clarithromycin-containing triple therapy for Helicobacter pylori eradication is inducing increased long-term resistant bacteria communities in the gut. Gut. gutjnl-2023-329792. https://doi.org/10.1136/gutjnl-2023-329792 PMID:37364984
3. Knaze V, Freisling H, Cook P, Heise K, Acevedo J, Cikutovic M, et al. (2023). Association between salt intake and gastric atrophy by Helicobacter pylori infection: first results from the Epidemiological Investigation of Gastric Malignancy (ENIGMA). Eur J Nutr. 62(5):2129–38. https://doi.org/10.1007/s00394-023-03132-w PMID:36964250
4. Li M, Park JY, Sheikh M, Kayamba V, Rumgay H, Jenab M, et al. (2023). Population-based investigation of common and deviating patterns of gastric cancer and oesophageal cancer incidence across populations and time. Gut. 72(5):846–54. https://doi.org/10.1136/gutjnl-2022-328233 PMID:36241389
5. Park JY, Herrero R (2021). Recent progress in gastric cancer prevention. Best Pract Res Clin Gastroenterol. 50–51:101733. https://doi.org/10.1016/j.bpg.2021.101733 PMID:33975687
6. Arnold M, Park JY, Camargo MC, Lunet N, Forman D, Soerjomataram I (2020). Is gastric cancer becoming a rare disease? A global assessment of predicted incidence trends to 2035. Gut. 69(5):823–9. https://doi.org/10.1136/gutjnl-2019-320234 PMID:32001553
7. Herrero R, Heise K, Acevedo J, Cook P, Gonzalez C, Gahona J, et al.; ENIGMA Chile study group (2020). Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: the ENIGMA study in Chile. PLoS One. 15(9):e0237515. https://doi.org/10.1371/journal.pone.0237515 PMID:32898138
8. Park JY, Nam BH, Herrero R, Choi IJ (2017). Effect of Helicobacter pylori eradication on gastric cancer prevention in Korea: a randomized controlled clinical trial. In: Matsui S, Crowley J, editors. Frontiers of biostatistical methods and applications in clinical oncology. Singapore: Springer; pp. 315–330. https://doi.org/10.1007/978-981-10-0126-0_19
9. Park JY, Polaka I, Parshutin S, Kikuste I, Isajevs S, Santare D et al. (2019). Trial profile: pilot study of the multicentre randomised trial of H. pylori eradication and pepsinogen testing for prevention of gastric cancer mortality (the GISTAR Pilot study). Microb Health Dis. 1:e165. https://doi.org/10.26355/mhd_201912_165
10. Leja M, Park JY, Murillo R, Liepniece-Karele I, Isajevs S, Kikuste I, et al. (2017). Multicentric randomised study of Helicobacter pylori eradication and pepsinogen testing for prevention of gastric cancer mortality: the GISTAR study. BMJ Open. 7(8):e016999. https://doi.org/10.1136/bmjopen-2017-016999 PMID:28801429
11. IARC Helicobacter pylori Working Group (2014). Helicobacter pylori eradication as a strategy for preventing gastric cancer (IARC Working Group Reports, No. 8). Available from: https://publications.iarc.who.int/391.