A young physician who died of stomach cancer wanted Canadians to know that screening for bacteria with a blood test could help with prevention.
Agnes Kwasnicka was an active doctor in Toronto when a "benign looking" cyst on her belly was diagnosed as metastatic cancer.
"In the doctor's office the words 'metastatic carcinoma' hung in the air as I sat in stunned silence," Kwasnicka wrote on a profile for Young Adult Cancer Canada before her death in April.
"This was a mistake, obviously! I was a healthy 35-year-old with what seemed like no major medical problems. I rode my bike 45 minutes to and from work, for goodness sake."
"My only risk factor for stomach cancer was that I had Helicobacter pylori infection years ago (this is the bug that causes ulcers and increases the risk of stomach cancer). If you have indigestion, reflux or chronic stomach pain, get tested for this bug and get treatment."
About 1,800 Canadians die from stomach cancer each year. A large fraction can be attributed to H. pylori infection, said Dr. Paul Moayyedi, a gastroenterologist at McMaster University in Hamilton.
"If someone had screened her, at an earlier age, it may have prevented her from getting stomach cancer," Moayyedi said of Kwasnicka's case. "It's not a guarantee, but there's certainly that possibility."
H. pylori can be killed with simple antibiotics.
An Ontario government panel looked at the high rates of H. pylori infections in some Aboriginal and Inuit communities as well as the high prevalence of gastric cancer in Asian countries such as China. The panel members also considered the safety of testing and treatment and their cost-effectiveness.
"There is pretty good evidence but not rock solid, robust evidence that testing and treating large populations would actually reduce cancer," said health policy professor Terry Sullivan of the University of Toronto, who was part of the committee that decided the costs weren't justified.
Agnes Kwasnicka's widower, Greg Wasney of Vancouver, remembers her as vibrant, caring, and selfless.
"She was the most amazing person I've ever known and I learned so much from her," Wasney said.
"She spent a lot of time educating people, sharing her knowledge. She wanted everyone around her to have better life."
With files from CBC's Kelly Crowe