 Screening for gastric cancer gained popularity in Japan, where the disease is highly prevalent. This approach is not cost-effective in the Western word, where gastric cancer incidence is low, but still cost-effective in high-risk population: Helicobacter pylori infected people, first degree relatives of gastric cancer patients, patients with autoimmune atrophic gastropathy and pernicious anemia, families with HNPCC and patients who underwent partial gastrectomy. Since treatment for gastric cancer is not very effective and 5-year-survival is low, it is recommended to screen this population with periodic gastroscopy and biopsies. The finding of high grade dysplasia or early gastric cancer will enable early intervention and cure. In addition H. pylori may be diagnosed in gastric biopsies direct evaluation in HE, Giemsa or Genta staining, culture, PCR or urease rapid test, mucin secretion pattern may be assessed by immunohistochemistry with PAbs, MAbs or lectins, JCV TAg may be demonstrated by IMH or PCR. 