欧洲每年胃癌病例的绝对数量正在上升。欧盟理事会建议对胃癌发病率和死亡率较高的国家或地区实施胃癌筛查。然而，截至2024年，欧洲尚未启动有组织的胃癌筛查计划。减轻胃癌负担的方法有多种，但幽门螺杆菌（H. pylori）的筛查和治疗策略似乎是最适合欧洲的。必须指出的是，抗生素使用的增加将与这一策略相关。欧盟仅建议进行有组织的基于人群的癌症筛查，因此胃癌筛查也有望满足有组织的筛查计划的标准。在这方面，在欧洲全面实施胃癌预防之前，需要考虑筛查组织的几个方面；其中包括目标群体的年龄范围、测试类型、幽门螺杆菌根除方案和监测策略。目前，正在进行的项目（GISTAR、EUROHELICAN、TOGAS 和 EUCanScreen）预计将提供缺失的证据。来自决策者和包括弱势群体在内的潜在目标群体的反馈对于规划该计划非常重要。本文概述了欧洲当局最近的决定、欧洲胃癌实施的进展以及预期的挑战。最后，提出了一种在欧洲进行胃癌筛查的潜在算法。© 作者（或其雇主）2024。根据 CC BY-NC 允许重复使用。禁止商业再利用。请参阅权利和权限。英国医学杂志出版。

The absolute number of annual cases of gastric cancer in Europe is rising. The Council of the European Union has recommended implementation of gastric cancer screening for countries or regions with a high gastric cancer incidence and death rates. However, as of 2024 no organised gastric cancer screening programme has been launched in Europe.There are several ways to decrease gastric cancer burden, but the screen and treat strategy for Helicobacter pylori (H. pylori) seems to be the most appropriate for Europe. It has to be noted that increased use of antibiotics would be associated with this strategy.Only organised population-based cancer screening is recommended in the European Union, therefore gastric cancer screening also is expected to fulfil the criteria of an organised screening programme. In this respect, several aspects of screening organisation need to be considered before full implementation of gastric cancer prevention in Europe; the age range of the target group, test types, H. pylori eradication regimens and surveillance strategies are among them. Currently, ongoing projects (GISTAR, EUROHELICAN, TOGAS and EUCanScreen) are expected to provide the missing evidence. Feedback from the decision-makers and the potential target groups, including vulnerable populations, will be important to planning the programme.This paper provides an overview of the recent decisions of the European authorities, the progress towards gastric cancer implementation in Europe and expected challenges. Finally, a potential algorithm for gastric cancer screening in Europe is proposed.© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.