GISTAR - multicentric randomized study of H.pylori eradication and pepsinogen testing for prevention of gastric cancer mortality

Cancers of the digestive system form the largest group of malignant diseases worldwide, accounting for 3.88 million new cases and being responsible for 2.83 million deaths annually. (Global Cancer Observatory)

Colorectal cancer (cancer of the large intestine) and stomach cancer are among the most common digestive cancers. Most of these cancers are preventable, and if diagnosed early, they are treatable, including colorectal and gastric cancers.

The protocol for the GISTAR study is available at:

GISTAR is an initiative of the University of Latvia (UL) and international experts aimed at studying the opportunities and efficacy of digestive cancer screening and early detection. The GISTAR Project concept was developed based on the results of the European Social Fund Project "Interdisciplinary research group for early cancer detection and cancer prevention," No. 2009/0220/1DP/ (

This study aims to search for new intervention strategies to prove the efficacy of gastric cancer screening and optimize colorectal cancer screening in high-risk areas.

Healthy individuals aged 40-64 are invited to express their willingness to participate in the project. A questionnaire is filled out to summarize the lifestyle factors of the individuals as well as their previous medical conditions and complaints. Those who express their willingness to participate are invited for further analysis. The selection is made randomly, but those requiring immediate medical assistance are recommended to undergo diagnostic testing. The selected individuals are offered a blood test to identify signs of atrophy in the stomach (a condition associated with an increased risk of gastric cancer development) and a test for occult blood in feces (to identify people at risk for colorectal cancer). Patients with a positive test result (i.e., a deviation from the normal result) are invited for further diagnostic investigations. Further follow-up of the enrolled individuals is planned for the next 10-15 years.

More information on project website

The GISTAR study is partly funded by the ERDF (European Regional Development Fund) project "Practical Studies", 2nd phase, project ID Nr. "Optimisation of H.pylori eradication therapy for population-based gastric cancer prevention" and FLPP (Fundamental and Applied Research Projects) within the framework of the Latvian Program, project no. lzp-2018 / 1-0135 "Study on the implementation of a set of measures to prevent gastric cancer mortality by eradicating H.pylori infection and timely detection of gastric pre-cancer conditions".