Core Framework & Diagram Chronic Inflammation and Cancer

Current mainstream consensus (including China consensus opinions and Asia-Pacific consensus) is: unless there are clear contraindications, adults testing H. pylori positive are recommended to receive eradication treatment, regardless of symptoms. Eradication therapy is usually ten to fourteen days of triple or quadruple antibiotic combination (proton pump inhibitor + two antibiotics), with eradication success rates of eighty to ninety percent under standardized treatment. Over four weeks after treatment ends, a breath test is needed to confirm successful eradication.

Not necessarily immediately, but regular follow-up is essential. Whether treatment is needed depends on multiple factors: HBV DNA level (viral load), HBeAg status, degree of hepatic inflammation and fibrosis, and age and family history. Patients with normal liver function but high viral load or signs of liver fibrosis are usually advised to start antiviral treatment. Develop an individualized plan under hepatologist guidance — don't ignore follow-up just because 'liver function is normal.'

First distinguish between hs-CRP and regular CRP, and between acute elevation versus sustained elevation. A single CRP elevation (especially with recent infection, surgery, or other acute event) has no diagnostic meaning for chronic inflammation. If after excluding acute causes, hs-CRP still persistently exceeds 1 mg/L, actively find and address chronic inflammation sources: screen for H. pylori and hepatitis; assess weight and waist circumference; check periodontal health; evaluate sleep and stress status. The focus is eliminating sources, not simply trying to 'lower the CRP number.'

There's reasonable evidence, but effect size isn't large. Mediterranean diet (high fish, olive oil, vegetables/fruits, whole grains; low red meat, processed foods) correlates with reduced inflammatory markers (hsCRP, IL-6) and moderately reduced multiple cancer (colorectal, breast, prostate) incidence in multiple prospective studies. Reducing ultra-processed foods (high added sugars, refined fats, emulsifiers) is considered beneficial for reducing gut and systemic inflammation. But 'anti-inflammatory diet' is a fairly vague concept — there's no single 'magic anti-inflammatory food'; overall dietary patterns matter more than any single food.

From a cancer prevention perspective, treatment is recommended. H. pylori is a definitive Group 1 carcinogen (WHO classification), continuously pushing toward gastric cancer through the chronic gastritis → atrophic gastritis → intestinal metaplasia → gastric cancer progression. Taiwan Matsu's large-scale screening and eradication project showed gastric cancer incidence decreased over fifty percent after fifteen years. Standard triple or quadruple eradication therapy (approximately ten to fourteen days antibiotics + proton pump inhibitor) has over eighty percent efficacy with mild side effects. The earlier the eradication — before irreversible gastric mucosal damage — the better the preventive effect. For Asian populations (including Malaysia, Singapore, China, Taiwan) with higher H. pylori infection rates (some regions over fifty percent in adults), active screening and eradication is one of the most evidence-based and clearly beneficial gastric cancer prevention measures.