Implementing occupational-based Helicobacter pylori screening for gastric cancer prevention

This doctoral thesis investigates Hp infection as a modifiable determinant of health, focusing on its carcinogenic role and on the potential of Hp control to reduce the burden of gastric cancer. The overarching aim is to explore the feasibility and effectiveness of workplace-based Hp screening, where occupational health surveillance is a unique, structured, and underutilized opportunity for large-scale gastric cancer prevention. The thesis is structured as a collection of studies conducted and published (or in publication) during the PhD program. These include investigations into the epidemiology of Hp–related gastric cancer, global estimates of the burden of gastric cancer attributable to Hp, and analyses of cancer attributable to infectious agents in Italy. Furthermore, this research explores the implementation of workplace-based Hp screening according to a Total Worker Health approach, as through the ongoing Horizon Europe project Cancer Prevention at Work, which extends the scope of this thesis to an international context and to other oncogenic infections. The specific goal of this project is the implementation of a screening of Hp infection for gastric cancer prevention in a population of hospital workers, in specific the employees of Sant’Orsola University Hospital in Bologna. The results of this study, conducted between 2023 and 2025, provides real-world evidence on the feasibility and acceptability of workplace-based Hp screening for gastric cancer prevention, and contributes to the knowledge of Hp epidemiology in hospital workers.