We read with interest the article by Fendrik et al1 in the January issue of the ARCHIVES. The authors evaluated the cost-effectiveness of primary prevention of gastric cancer based on the eradication of the Helicobacter pylori infection in different epidemiological contexts and using different strategies. Both single H pylori serological testing and H pylori testing followed by confirmatory tests resulted in a positive cost-effective balance, proportional to the cancer risk associated with the considered population.