The net effect of Helicobacter pylori eradication in asymptomatic individuals can be unfavorable. The systematic review1 associates eradication of H pylori infection with a reduced incidence of gastric cancer. The benefits of eradication vary with baseline gastric cancer incidence (which ranged from 34.3 to 10,256.4 per 100,000 persons-years), but the authors state that they apply to all levels of baseline risk. They claim thatresults support mass Hp screening and eradication as a viable preventive strategy, that should be implemented in high-risk populations/areas, especially in those with an incidence rate >150/100,000 person-years [below which the protection loses statistical significance].