Background/Objectives: Helicobacter pylori HP is a Gram-negative bacterium linked to peptic ulcers chronic gastritis and gastric cancer Chronic HP infection is the leading confirmed cause of gastric cancer and is estimated to account for around 90% of non-cardia gastric cancer cases HP is also the only bacterium classified as type I carcinogen by the IARC In Spain a 2018 seroprevalence survey showed that 77.4% of individuals in the MCC Spain controls in Asturias are seropositive for HP The seropositivity was significantly associated with higher BMI older age and male gender These findings support a workplace-based HP screening pilot in Asturias under the Total Worker Health framework Objective: To assess the feasibility and outcomes of workplace-based HP screening in Asturias in line with the Total Worker Health framework.

Methods: Workplace-based HP screening among Asturias employees aged 25–65 years attending occupational health surveillance who provide informed consent All participants will complete a questionnaire on sociodemographic, occupational, and health factors HP serology (high sensitivity) and stool antigen testing (high specificity) will be performed positive cases will be referred for treatment. Individuals with diarrhea or current use of antibiotics proton pump inhibitors, H2 blockers or antacids will be temporarily excluded from stool antigen testing until discontinuing these medications for 4 weeks A follow-up questionnaire will be administered to assess treatment uptake and health status of HP positive workers.

Results: From May 2024 to January 2025, 520 workers who met the criteria and signed a consent form were invited to participate in the screening. A total of 368 workers agreed, with a response rate of 71%. The gender ratio was 45% women. 100% and 78%, respectively, completed the baseline questionnaire and the qualitative study questionnaire. 24.72% of workers who underwent immunoglobulin G, A, and M testing tested positive for one of the three Igs. And 32.14% of workers who underwent the stool antigen test tested positive for the presence of antigen in stool and were referred to primary care with an explanatory document about the program and the worker's results.

Conclusions/Recommendations: The Total Worker Health based Helicobacter pylori prevention strategy leverages public health measures to address HP infection among workers by integrating workplace-interventions Over the medium term, health promotion, cost-effectiveness, and feasibility of screening strategies will be evaluated to enhance awareness of H. pylori infection.

Financiación: CPW Horizon Cancer Eu Proposal 101104716.