Dr Barry Marshall says eradicating this infection can prevent gastric cancer 

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Eradicating Helicobacter pylori (H. pylori) infection early could become an important strategy for preventing gastric cancer, Nobel laureate and gastroenterologist Dr Barry Marshall said, stressing the need for wider testing, appropriate treatment and confirmation that the infection has been cleared.

Marshall, who shared the 2005 Nobel Prize in Physiology or Medicine with Robin Warren for their discovery of H. pylori and its role in gastritis and peptic ulcer disease, said the bacterium should no longer be regarded only as a cause of ulcers.

“H. pylori is much more than an ulcer organism. If the infection persists for many years, it can cause chronic inflammation in the stomach and increase the risk of gastric cancer. That gives us an opportunity because this is a potentially preventable cause of cancer,” Marshall told PTI.

Marshall was in India to attend the World Congress of Gastroenterology (WCOG 2026) in the national capital.

Held in India for the first time, the four-day event, which concluded on October 3, brought together around 3,000 delegates from 61 countries to discuss the changing global burden of gastrointestinal and liver diseases, including H. pylori infection, gastric cancer prevention, early diagnosis and treatment.

His comments come amid renewed global focus on population-based H. pylori “screen-and-treat” programmes for gastric cancer prevention.

The International Agency for Research on Cancer (IARC) working group has recommended such programmes in populations where the benefits are expected to outweigh potential harms.

Marshall said the priority should be to identify infected individuals and ensure they receive effective eradication therapy.

“If we can find the infection before there has been extensive damage to the stomach, we have a much better chance of preventing the chain of events that can eventually lead to cancer,” he said.

However, rising antibiotic resistance is emerging as a major challenge to this approach, he highlighted.

A 2026 review in Gastroenterology noted that increasing antimicrobial resistance is threatening the success of established H. pylori treatment regimens, while concerns also remain about the effects of repeated antibiotic exposure on the microbiome.

“We cannot simply keep giving the same antibiotics and expect the same results. Resistance varies between countries and even between regions, so treatment needs to take local resistance patterns into account,” Marshall said.

The IARC guidance similarly emphasises antibiotic stewardship, treatment based on local resistance patterns and follow-up testing to determine whether eradication has been successful.

Marshall said India, where H. pylori infection is common, has an important role to play in generating evidence on local bacterial strains and antibiotic resistance.

“India has a very large population with H. pylori, so it is an important setting for research. We need to understand which strains are circulating, what antibiotics are still effective and how we can make testing and treatment accessible,” he said.

According to the IARC guidance, Indian recommendations have included bismuth-containing quadruple therapy in areas with high clarithromycin resistance, highlighting the importance of regional resistance patterns in treatment decisions.

Marshall also stressed that successful treatment should not be assumed simply because symptoms improve.

“Treating the patient is only half the job. We should confirm that the bacterium has actually been eradicated. Otherwise, the patient may continue to carry the infection and remain at risk,” he said.

He said non-invasive testing could make detection easier and help expand screening.

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