Is Helicobacter pylori infection in childhood a risk factor for gastric cancer?

Helicobacter pylori infection is associated with chronic gastritis and pept ic ulcer disease. Furthermore, the World Health Organization has classified this organism as a carcinogen for gastric cancer. H pylori infection is ma inly acquired in childhood. Children with H pylori infection are asymptomat ic except for a very small number that develop peptic ulcer disease. Howeve r, if H pylori gastritis is associated with gastric cancer, do pediatrician s need to screen children for this infection and treat those who are infect ed? In an attempt to determine the significance of the association between H pylori and gastric cancer, we have reviewed all of the English language l iterature on this topic. H pylori infection seems to be associated with an increased risk of developing gastric cancer. However, only a small number o f infected individuals (similar to1%) will develop gastric cancer. Furtherm ore, there are potential cofactors other than H pylori that could be equall y important. The effect of the eradication of H pylori alone on the develop ment of gastric cancer is unknown. Based on our knowledge to date, we sugge st that it is not indicated to treat all children with H pylori infection b ecause of the risk of developing gastric cancer or to institute a screening and treatment program.