Evidence map›Paper›PMID 41920508›Full record

ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2026

Gastric cancer secondary prevention in dyspeptic patients.

Giulia Fiorini, Massimo Rugge, Nimish Vakil, Antonietta D'Errico, Matteo Pavoni, Stefano Guzzinati, Angelo Zullo, Luigi Gatta, Gabriella Massarenti, Beatrice Rosa and 6 more

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Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Giulia FioriniCardiovascular Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy.ORCID 0000-0003-0381-8302
Massimo RuggeDepartment of Medicine-DIMED, Anatomic Pathology & Cytopathology Unit, University of Padova, 35100, Padova, Italy. massimo.rugge@unipd.it.ORCID 0000-0002-0679-0563
Nimish VakilDepartment of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Ave, Madison, WI, 53792, USA.ORCID 0000-0002-3765-9111
Antonietta D'ErricoDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.ORCID 0000-0003-2747-3732
Matteo PavoniDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.ORCID 0000-0001-6475-3026
Stefano GuzzinatiAzienda Zero, Veneto Cancer Registry - RTV, Padova, Italy.ORCID 0000-0002-4908-5506
Angelo ZulloGastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy.ORCID 0000-0003-2329-8105
Luigi GattaDipartimento Staff della Direzione, U.O:C. Governo della Domanda Ambulatoriale e della Diagnostica, Azienda USL Toscana Nord-Ovest , Carrara, Italy.ORCID 0000-0001-5789-3813
Gabriella MassarentiDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Beatrice RosaDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Cristina MarchesaniDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Giulia CollatuzzoDepartment of Biomedical and Clinical Sciences (DIBIC), University of Milan, Milano, Italy.ORCID 0000-0002-2309-7365
Cinzia PapadiaDepartment of Gastroenterology, Queen Mary University of London, London, UK.ORCID 0000-0003-2234-8262
Giovanni BarbaraDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.ORCID 0000-0001-9745-0726
Claudio BorghiCardiovascular Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy.ORCID 0000-0001-8039-8781
Dino VairaCardiovascular Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy.ORCID 0000-0001-9086-3675

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn dyspeptic patients without alarm symptoms, the “Test-and-Treat” (TT) strategy aims to alleviate symptoms and prevent adverse outcomes. An alternative workup expands the TT-strategy by incorporating esophagogastroduodenoscopy (Test-Treat-and-Scope [TT-S]).

objectiveThis prospective cross-sectional study provides evidence-based insights into the clinical workup of dyspepsia by applying the TT and TT-S options.

designIn a consecutive cohort of 2171 dyspeptic patients without alarm symptoms, H. pylori (Hp) status was assessed by 13C-Urea Breath Test, Rapid urease test, and histology. Histology profiling was based on six biopsies and included atrophy staging (OLGA-system).

resultsAmong Hp-positive and Hp-negative patients, the prevalence of mucosal atrophy was 22.2% and 1.3% (p < 0.001), respectively. In the study population, 92.5% did not exhibit atrophic disease (OLGA stage 0). Among Hp-positive patients, mucosal atrophy occurred in 142/640 subjects. Nine in 640 (1.4%) Hp-positive patients presented advanced atrophy (OLGA-stages III-IV), considered at high-risk for gastric cancer. The overall prevalence of high-risk OLGA stages (III-IV) was below 1.5% (all Hp-positive). The mean age of patients with OLGA stages III-IV was 15 years older than that of non-atrophic patients (p < 0.0001). In all atrophic OLGA-stages, Hp-positive subjects dominated over the Hp-negative (test-for-trend; p < 0.0001). None of the Hp-negative subjects showed extensive atrophy (OLGA-stages III-IV).

conclusionIn the considered epidemiological context, advanced gastric atrophy (OLGA-stages III-IV), consistently recognized as at risk of cancer development, only occurred in Hp-positive patients over 55 years. These results support the priority of the TT-S-strategy in Hp-positive patients older than 55, even in the absence of alarm symptoms.

Indexed as

DyspepsiaHelicobacter InfectionsSecondary PreventionStomach NeoplasmsAdultAgedAtrophyBreath TestsCross-Sectional StudiesEndoscopy, Digestive SystemFemaleGastric MucosaHelicobacter pyloriHumansMaleMiddle AgedBREATH testCancer preventionEGDGastric cancerGastritisHelicobacter pyloriOLGA staging

Identifiers

PMID41920508
PMCPMC13124805

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.