Recently, the U.S. Department of health and human services released the 15th edition of carcinogen report, including 8 new carcinogens, and Helicobacter pylori was listed as a clear carcinogen for the first time. As soon as the news came out, the "panic" of Helicobacter pylori hit on social media. "I seem to be familiar with the name Helicobacter pylori, but I always feel that many people have been infected, so I didn't pay much attention to it. Unexpectedly, it is a clear carcinogen." Most netizens were shocked to see # the microblog hot search that the United States listed Helicobacter pylori as a clear carcinogen # in the microblog. "Many people have been infected with Helicobacter pylori, which doesn't mean it doesn't matter. On the contrary, we should pay more attention to it because the infection rate is very high." According to Zhang Zhenyu, director of the Department of Gastroenterology of Nanjing First Hospital, the attention to Helicobacter pylori this time is just an opportunity to let the public know more about this disease with an infection rate of more than 40% in China. More than 85% of gastric cancer worldwide is attributed to Helicobacter pylori infection Helicobacter pylori infection is closely related to unhealthy lifestyle Although many people have heard of Helicobacter pylori, there are not many people who really understand this infectious disease. This is Zhang Zhenyu's clinical experience for many years. He said that in fact, as early as 1994, the international agency for research on cancer (IARC) under the World Health Organization identified Helicobacter pylori as a class I carcinogen of gastric cancer. "It can be seen that Helicobacter pylori infection has never been an irrelevant minor disease, but the attention of the Chinese people is not enough.". "Therefore, it is particularly important to improve people's health literacy." Qiu Haibo, deputy chief physician of gastric surgery at the cancer prevention and treatment center of Sun Yat sen University, lamented, "Helicobacter pylori infection is closely related to some unhealthy lifestyles. Many times, if we pay more attention, the possibility of infection will be much less." Qiu Haibo will repeatedly explain the causes of infection to patients with related diseases and their families, so as to attract everyone's attention. For example, he said, "if an unhealthy lifestyle leads to the decline of body immunity, it may indirectly lead to the increase of infection rate; in addition, kissing between lovers or sharing dishes and chopsticks between families can also lead to Helicobacter pylori infection." If you find out Helicobacter pylori, do you have to worry about cancer? "More than 85% of gastric cancer worldwide is attributed to Helicobacter pylori infection." Zhang Zhenyu listed this remarkable data and analyzed that Helicobacter pylori infection is the most important controllable risk factor for the prevention of gastric cancer. A large number of research evidence shows that the occurrence of intestinal gastric cancer (accounting for the majority of gastric cancer) is the result of Helicobacter pylori infection, environmental factors and genetic factors. It is estimated that about 90% of non cardiac gastric cancer is associated with Helicobacter pylori infection; The overall role of environmental factors in the occurrence of gastric cancer is less than that of Helicobacter pylori infection; Genetic factors play a decisive role in about 1% ~ 3% of hereditary diffuse gastric cancer. "It can be seen that among the many factors leading to gastric cancer, the prevention of Helicobacter pylori infection is the most controllable factor. This is also an important reason why we should pay attention to Helicobacter pylori infection." He concluded. "We should pay attention to Helicobacter pylori infection, but we don't have to be too nervous." Qiu Haibo explained that clinically, about 90% of people infected with Helicobacter pylori will not show any symptoms, a small number will have symptoms such as dyspepsia, stomach pain or oral odor, and only a few infected people are diagnosed with gastric cancer. "Helicobacter pylori infection will first lead to chronic gastritis, then atypical hyperplasia, including mild atypical hyperplasia and severe atypical hyperplasia, and finally cancer. It does not necessarily develop forward in the process of evolution, and only 1% of the probability will lead to gastric cancer." Qiu Haibo's words let many people infected with Helicobacter pylori put down their excessive anxiety. But we must pay attention to Helicobacter pylori. Zhang Zhenyu repeated his view again. "Because China is a country with a high incidence of Helicobacter pylori infection, and Helicobacter pylori infection is also the main cause of gastric cancer in China." In Zhang Zhenyu's view, the more the public knows about the harm of gastric cancer, the more helpful it is to promote the prevention of gastric cancer. "Eradication of Helicobacter pylori can reduce the incidence of gastric cancer, especially early eradication." This is the conclusion of Zhang Zhenyu's clinical and research for many years, and it is also the consensus of domestic experts. "In China, most patients with gastric cancer are found to be in advanced stage and have a poor prognosis. If they are found early, they can be treated in time and have a good prognosis." Zhang Zhenyu said, but early gastric cancer is generally asymptomatic or symptoms lack specificity, which is difficult to detect in time. "So once cancer is found, it will be very troublesome. If Helicobacter pylori can be treated in time to reduce the risk of cancer, of course, our health will be more guaranteed." Unless active intervention measures are taken, Helicobacter pylori infection will not disappear by itself How to find out Helicobacter pylori infection Is Helicobacter pylori infection detected and must be treated? "We suggest early treatment. The earlier we treat Helicobacter pylori infection, the more secure our health will be." Zhang Zhenyu said, "in the past, many people felt that if there were no serious symptoms, they could not be cured, but now most domestic experts believe that they should be treated as soon as possible." Because if not treated, it is easy to infect people around you, and it will also increase the possibility of suffering from gastrointestinal diseases. "There was a view that it would reinfect after treatment, so it can be ignored without obvious symptoms. However, according to our current research, the reinfection rate of Helicobacter pylori after treatment is very low, and the reinfection rate of the general population is only about 1.5% In Zhang Zhenyu's view, early treatment of Helicobacter pylori can maximize benefits. "For people with a family history of gastric cancer, eradicating Helicobacter pylori can reduce their risk of gastric cancer by 73%." Zhang Zhenyu once again used the research data to prove the importance of early treatment of Helicobacter pylori. If there is no timely treatment, what diseases will Helicobacter pylori infection cause? Li Lei, director of the general medicine department of the Affiliated Hospital of Xuzhou Medical University, concluded that about 25% to 30% of people infected with Helicobacter pylori will have different degrees of gastrointestinal diseases, such as dyspepsia, chronic gastritis, peptic ulcer, gastric malignancy and so on. "In fact, not only gastrointestinal diseases, Helicobacter pylori infection is also closely related to a variety of extragastrointestinal diseases, such as iron deficiency anemia, cardiovascular diseases, cerebrovascular diseases and so on." Li Lei said. Zhang Zhenyu also stressed: "for some special groups, it is more important to eradicate Helicobacter pylori infection, such as the elderly." The infection rate of Helicobacter pylori in the elderly population is high. Eradication of Helicobacter pylori can improve the gastrointestinal symptoms of elderly patients, prevent or delay the occurrence of gastric mucosal atrophy and intestinal metaplasia to some extent, and even reverse some gastric mucosal atrophy or intestinal metaplasia. "However, elderly patients with Helicobacter pylori infection often suffer from cardiovascular, cerebrovascular, renal and other systemic diseases at the same time. Therefore, before Helicobacter pylori treatment, we should choose a personalized and standardized treatment scheme according to the patient's previous medication, physiological characteristics, disease and adverse drug reactions." Zhang Zhenyu said. "We also want to make it clear that unless active intervention measures are taken, Helicobacter pylori infection will not disappear by itself." Zhang Zhenyu reminded that Helicobacter pylori related diseases not only endanger people's health, but also cause a great burden on social and family health care. "Therefore, it is urgent to eradicate Helicobacter pylori to reduce the incidence of related diseases." It is understood that his view is also the consensus of domestic experts in relevant fields. According to the expert consensus on the prevention, control and management of Helicobacter pylori infection in Chinese households issued in 2021, at present, China mainly adopts two strategies for the diagnosis, treatment and management of Helicobacter pylori infection: detection and treatment in areas with low infection rate and screening and treatment in areas with high infection rate. "In other words, in areas with low infection rate, people with dyspepsia symptoms are recommended to do relevant examinations on their own. If they are found to be infected with Helicobacter pylori, they should be treated. For areas with high infection rate, China is striving for large-scale Helicobacter pylori screening. For example, taking the community as the unit, community doctors and community staff can make relevant popular science and education for the masses Examination and detection of people infected with Helicobacter pylori suggest treatment unless the patient's own body has countervailing factors. " He also reminded that people with a family history of gastric cancer and other related diseases should be tested regularly. "In recent years, Japan and South Korea have begun to implement a national Helicobacter pylori eradication plan to reduce the incidence of gastric cancer and Helicobacter pylori infection related diseases, so as to save later medical expenses." In Zhang Zhenyu's view, a national eradication plan is necessary. His suggestion is "step by step, with the efforts of the government and society at all levels, we should realize the national Helicobacter pylori eradication plan as soon as possible". About 64% of families in China have at least one family member infected with Helicobacter pylori To prevent bacteria from entering the mouth, the most important thing is to promote the serving of individual dishes. Talking about the way to prevent Helicobacter pylori, Zhang Zhenyu believes that as an infectious disease, using vaccine to prevent infection is certainly the best choice. "But there is no vaccine for clinical use." He said that there have been many attempts at the development of Helicobacter pylori vaccine at home and abroad for many years, but due to the complexity of antigen preparation and body reaction, the vaccine research is still in the stage of laboratory and clinical research and development. "In addition, some toothpaste claims to be anti Helicobacter pylori, which is also lack of scientific basis." Zhang Zhenyu said, "in the absence of a vaccine, the most important thing to prevent Helicobacter pylori is to cultivate healthy living habits." "Human to human transmission is an important way of Helicobacter pylori transmission, and there is an obvious family aggregation phenomenon of Helicobacter pylori infection. Intra family transmission is an important way of Helicobacter pylori transmission. According to the current research, about 64% of families in China have at least one family member infected with Helicobacter pylori." Zhang Zhenyu reminded that because people infected with Helicobacter pylori rarely recover without treatment, family members infected with Helicobacter pylori are always a potential source of infection, and there is the possibility of continuous transmission. In Zhang Zhenyu's view, the most important thing to reduce the possibility of infection of Helicobacter pylori is to promote the serving of individual dishes, because this can greatly reduce the possibility of "bacteria entering from the mouth". "The serving of individual dishes is not a problem of willingness, but rather a need to do." Zhang Zhenyu said that the so-called meal sharing means that meals and tableware are separated and dedicated by special personnel. "We Chinese think it's lively to eat together and eat with each other. However, if one of the people eating together carries germs, the tableware he has used may carry germs. When others use his tableware or eat the dishes moved by his tableware, they are likely to be infected." Novel coronavirus pneumonia is not only a Helicobacter pylori, but also infected with hepatitis B virus, pneumonia virus, anaerobic Streptococcus, oral coccus, and new crown pneumonia virus, Zhang Zhenyu introduced. "So when having dinner, it's best to divide the dishes and eat your own. At least use public chopsticks, which must be done." Moreover, it is more necessary to advocate serving of individual dishes for families with children. Li Lei reminded them that "many old people are old."