Evidence points to the importance of improving diet and eradicating H. pylori infection. A diet rich in fresh fruits and vegetables without highly salted, preserved, or smoked food will theoretically offer benefits in primary prevention. In countries where the incidence of stomach cancer is high, screening for H. pylori may be effective for secondary prevention. To this end, programs of mass screening and eradication of H. pylori by antibiotics are being performed in Japan. However, because only a small proportion of individuals with H. pylori colonization develop stomach cancer, concerns have been raised regarding the possibility of antibiotic resistance by a mass H. pylori eradiation program. Use of vaccines against H. pylori may be an alternative approach.

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