New Zealand health authorities are considering the introduction of a national screening programme for Helicobacter pylori (H. pylori), a bacterium linked to gastric cancer. Experts emphasize the cost-effectiveness and potential health benefits of targeted “screen-and-treat” initiatives, particularly for high-risk groups such as the Māori and Pasifika populations.
A working group convened by the International Agency for Research on Cancer (IARC), part of the World Health Organization, found that screening and treating H. pylori infections could be financially advantageous. Modelling based on 2011 data estimated the cost at approximately NZ$12,000 per additional healthy year of life gained when offered to Māori adults aged 25 to 69. For a universal programme in that age group, the cost would be about NZ$24,600 per healthy life year, well below the NZ$45,000 benchmark for cost-effectiveness at the time.
“The data supports piloting an H. pylori screening programme in New Zealand,” said a lead researcher from the IARC working group. Gastroenterologist Dr. Tom Mules and other experts also advocate for screening but stress that it should be risk-stratified due to differing infection rates and cancer risks between populations.
Despite this, a national screening initiative has yet to be adopted. Dr. Karen Bartholomew, director of health gain development at Health New Zealand and chair of the National Screening Advisory Committee, noted that the committee has not yet reviewed H. pylori screening for gastric cancer, though it remains on the list for future consideration. Health New Zealand is currently conducting feasibility studies to explore adding H. pylori testing to existing bowel cancer screening programmes.
The Cancer Action Plan updated in 2026 includes establishing a pilot project design for H. pylori screening by 2027, reflecting commitment at an official level. However, implementation delays are not unique to New Zealand. Internationally, despite recommendations from IARC since 2014, only three population-wide H. pylori programmes currently exist.
The connection between H. pylori and stomach diseases was first demonstrated by Australian researchers Robin Warren and Barry Marshall in the 1980s, who challenged the prevailing belief that stomach acid prevented bacterial infection. Their work earned them the 2005 Nobel Prize in Medicine. Nearly all H. pylori infections are acquired in childhood, often within families, with certain ethnic groups more likely to harbour strains linked to higher cancer risks.
Currently, treatment in New Zealand typically involves a two-week course known as triple therapy, combining two antibiotics and an acid suppressant. While this approach clears infection in about 85% of cases, antibiotic resistance is rising. Clarithromycin resistance is estimated at roughly 10% locally but reaches around 40% in parts of Europe, where the drug has been largely abandoned.
Researchers at the Malaghan Institute are developing molecular tests that detect resistance genes directly from stool samples, enabling more precise antibiotic prescriptions. Efforts are also underway to develop a vaccine against H. pylori, although progress has been slow, with no effective vaccine available after decades of research.
In the meantime, medical professionals urge individuals, especially those in higher-risk groups, to seek testing and treatment promptly. Early intervention remains the best defense against long-term complications of untreated H. pylori infection, including gastric cancer.