Abstract

Introduction Gastric cancer (GC) is the fifth leading cause of cancer-related mortality globally; its main burden is concentrated in East Asia and some areas of Europe and Latin America. This study aims to develop an organized and structured GC prevention pilot program in intermediate-to-high-incidence countries in Latin America.Methods This study involved two strategies: (a) primary prevention for screen-and-treat H. pylori infection among individuals aged 30-39 years (n = 7500, 500 in 15 sites), and (b) primary and secondary prevention for individuals aged 40-75 years (n = 9600, 600 in 16 sites) with tiered risk stratification using an algorithm developed and validated in Chile (Gastrocalc: priority 1 to 6; age, sex, hypertension, IgG H. pylori, pepsinogen I and II, and Gastrin-17b), and high-quality esophagogastroduodenoscopy (EGD) evaluation.Results Pilot phases were successfully conducted in Chile and Colombia during 2023-2025. In Chile (Molina), 4152 asymptomatic individuals were tested with H. pylori prevalence of 46% (n = 113/246) in 2023, 34% (n = 504/1484) in 2024, and 32% (n = 609/1904) in 2025. The H. pylori prevalence among individuals aged 30-39 years (592/4152; 14.3%) was 37.8%. In Colombia, 1250 asymptomatic individuals were screened across four regions; in 2025, the prevalence of H. pylori among individuals aged 30-39 years was 69% (n = 895/1250). The validation of Gastrocalc included 866 individuals from 5 regions in Chile. The algorithm successfully identified 80.6% of OLGA III-IV patients and 100% of GC patients (Priority 1-4). Other countries will start activities in 2026.Conclusions This pioneering study will advance understanding and feasibility of urgently needed primary and secondary prevention for GC in Latin America.