A real-world workplace-based screening for Helicobacter pylori infection: the HPOS study.

OBJECTIVES

Helicobacter pylori (H.pylori) eradication contributes to gastric cancer (GC) prevention, yet many subjects are unaware of their infection status. We implemented a workplace-based H.pylori screening.

DESIGN

We implemented a cross-sectional screening with short-term follow-up among hospital workers (HWs), enrolled during occupational health surveillance (OHS). A stool antigen test (SAT) was adopted for H.pylori diagnosis. H.pylori-positive HWs were referred to their general practitioner (GP) or a gastroenterologist and were followed up at three months. Participation, prevalence of infection, participants' experience, and treatment rates were investigated through descriptive and multivariable analyses.

SETTING

The study was carried out between 2023 and 2025 at S.Orsola University Hospital in Bologna, Italy.

PARTICIPANTS

The study targeted HWs aged 40-65 employed at S.Orsola University Hospital.

RESULTS

Of 744 eligible HWs contacted, 550 were enrolled (73.9%), including 399 through OHS and 151 volunteers; the largest proportion of participants were women (74.7%) and nurses (40.2%). Dropout rate was 15.5% (n = 115), leaving 435 HWs with a SAT result. H.pylori prevalence was 16.6%. Men were less likely to participate than women (OR = 0.68, 95% CI = 0.47-0.99). Education was negatively associated with H. pylori infection (OR = 0.41, 95% CI = 0.18-0.93 for the highest educational level vs the lowest). No specific pattern was observed in relation to contact with a physician and treatment prescription. 58/72 H. pylori-positive HWs (80.6%) contacted a physician, 53 (73.6%) being prescribed a treatment and 13 (18.1%) undergoing upper endoscopy. Confirmatory test rate after treatment was suboptimal, while eradication rate was 97.3% when considering those with confirmatory test result (36/37 HWs). Across followed up HWs, the average quality of experience was 8.9/10; 13 had a family member tested following this intervention.

CONCLUSIONS

The intervention integrated into OHS was well received and extended to family members of the participants, suggesting that a workplace-based H.pylori screening might contribute to GC prevention. Replications in other workplaces are warranted.