There is rising international interest in H. pylori screen-and-treat programmes for stomach cancer prevention, but important treatment-related questions remain to be answered before screen-and-treat can be introduced in Aotearoa.
The overall goal of this study is to optimise H. pylori treatment guidelines and support equitable case management approaches in future screen-and-treat programmes.
H. pylori and stomach cancer
Most people with stomach cancer (about 9 in 10) have had a long-term infection with H. pylori that contributed to or caused their cancer. Screening and treating adults asymptomatic for H. pylori can cut stomach cancer risk by up to half, and has been recommended in higher-risk populations, such as Māori and Pacific. First-line treatment for H. pylori in Aotearoa is triple therapy: omeprazole, amoxicillin, and clarithromycin. However, increasing H. pylori resistance to clarithromycin may be limiting treatment effectiveness.
Research approach
This study will assess the appropriateness of current treatment by evaluating ethnicity-specific rates of H. pylori eradication and antibiotic resistance and drawing on participant experiences of H. pylori screen-and-treat. Findings will contribute Aotearoa-specific evidence to improve effectiveness and equity of stomach cancer prevention and treatment.
This research builds on and extends the H. pylori in Aotearoa New Zealand (HpANZ) Study.
Optimal treatment must have high success at eradicating H. pylori infection, particularly for groups such as Māori and Pacific who have the highest rates of infection. Therefore, local investigation is vital for understanding ethnicity-specific rates of antimicrobial resistance and acceptability of current treatment regimens.
Study objectives
H. pylori screen-and-treat is a recommended stomach cancer prevention strategy for high-risk populations, such as Māori and Pacific in Aotearoa. We are exploring our key questions using routine data analysis, clarithromycin resistance testing, and treatment experience interviews:
- For people treated and retested for H. pylori in the Northern region of Aotearoa, is H. pylori eradication successful, and does eradication success differ by ethnicity and/or deprivation?
- What is the level of clarithromycin resistance genetic markers in H. pylori diagnosed from a population-based sample in Aotearoa, and do resistance levels differ by ethnicity and/or deprivation?
- Although work towards piloting H. pylori screen-and-treat in Aotearoa is ongoing, questions remain about the appropriateness of currently-used first-line triple therapy including whether it is effective, equitable, and acceptable.
Contact us
Email andrea.teng@otago.ac.nz
Our people
- Dr Andrea Teng , Principal Investigator
- Dr Virginia Signal
- Associate Professor Melissa McLeod
- Professor James Stanley
- Associate Professor Kirsty Danielson
- Dr Stephen Inns
- Dr Viliami Puloka
- Julie Cooper
- June Atkinson
Research colleagues
- Dr Jin Young Park, IARC
- Dr Tom Mules, Malaghan Institute
Funding
New Zealand Cancer Society funded project, 2025–2027