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At the heart of general practice since 1960

H. pylori screening plea

By Emma Wilkinson

Screening everyone in their 40s for Helicobacter pylori would cut healthcare costs across the board, even in those testing negative for the bacterium, a UK study shows.

The researchers said their study showed it would be feasible to run a serology screening programme of 40- to 50-year-olds in general practice.

The study, conducted in 1,350 patients in West Yorkshire, found screening reduced the chance of incurring further dyspepsia-related healthcare costs by 19% overall – with an average saving of £11 per patient.

Patients told of a negative result were significantly less likely to consult for dyspepsia in the next two years than those kept in the dark.

The researchers calculated that for every nine people being told of a negative test, one would be prevented from seeking healthcare for dyspepsia in the future.

Study leader Dr Alex Ford, a clinical researcher at Leeds General Infirmary, said: ‘We published a paper in 2005 looking at people who tested positive that showed you saved money over 10 years with population screening.

‘But this is interesting because it's looking at the 73% who will test negative.'

The biggest reduction in GP time, prescriptions and endo-scopy for dyspepsia occurred in those who – although asymptomatic at the time of testing – had a history of dyspepsia. The researchers recommend serology screening everyone between 40 and 50 instead of the current ‘test and treat' approach.

Co-author Professor Paul Moayeddi, head of gastroenterology at McMaster University in Ontario, Canada, praised UK GPs for doing more ‘test and treat' than in most countries, but added: ‘I'd guess 25% of GP test and treat regularly while the rest do it intermittently or not at all.'

Dr Richard Stevens, a GP in Oxford and chair of the Primary Care Society for Gastroenterology, said a screening programme would have to be planned carefully due to ethnic and social differences in infection rates.

‘I could see it working in places where the H. pylori burden is high but I'm slightly sceptical about the need for it now. There are other screening programmes I'd like to see first, for example bowel screening.'

The study was published in November's Alimentary Pharmacology and Therapeutics.

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