Helicobacter pylori (H. pylori) infection is the most significant controllable risk factor for gastric cancer, and its eradication is a critical component of gastric cancer prevention in China. A family-based screening and treatment strategy for H. pylori aligns well with China’s public health needs. It demonstrates higher eradication success rate, lower recurrence rate, and superior cost-effectiveness, making it suitable for both high- and low-prevalence regions. Implementation of this family-based strategy can lead to greater precision, higher efficiency, and overall coverage in gastric cancer prevention in China, offering a scalable “China model” for global gastric cancer control.