Community-Based Helicobacter pylori Screening to Identify Gastric Cancer Risk Among Korean-Born Adults in the United States

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Objectives: Korean American adults have a high rate of gastric cancer in the United States. Although Helicobacter pylori , a major cause of noncardia gastric cancer, is commonly acquired early in life in regions with a high incidence of disease, data on infection history are limited. We assessed current and lifetime H pylori infection and examined gastric cancer prevention practices among Korean American adults. Methods: We conducted 14 community outreach events in Connecticut, New Jersey, and New York from June through October 2025. Participants completed a structured survey and underwent 13 C urea breath testing. We defined lifetime H pylori infection as prior clinician diagnosis and/or current test positivity. We recorded history, indication, and location of upper endoscopy. Results: Of 315 participants, 282 had valid test results. Participants reported prior clinician-diagnosed H pylori infection in 35.1% (n = 99) of cases, and 87.9% (n = 87) of these individuals reported treatment. We identified current infection in 18.4% (n = 52) of participants, including 8.0% (n = 7) of previously treated participants. Overall lifetime infection prevalence was 50.0% (n = 141) and remained similar across categories of duration of US residence. Among participants who reported endoscopy data, 78.4% (n = 225) had undergone esophagogastroduodenoscopy, most commonly for routine screening in the United States. Conclusions: Community-based outreach events identified a high prevalence of lifetime H pylori exposure among Korean-born adults, indicating persistent gastric cancer risk acquired before migration. However, high preventive endoscopy use indicates strong community engagement with prevention. Public health efforts can identify individuals at risk of gastric cancer and link them to eradication and surveillance to reduce gastric cancer disparities.

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