scholarly journals Helicobacter pylori eradication therapy to prevent gastric cancer: systematic review and meta-analysis

Gut ◽  
2020 ◽  
Vol 69 (12) ◽  
pp. 2113-2121 ◽  
Author(s):  
Alexander Charles Ford ◽  
Yuhong Yuan ◽  
Paul Moayyedi
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Helicobacter Pylori ◽  
Endoscopic Mucosal Resection ◽  
Meta Analysis ◽  
Eradication Therapy ◽  
Healthy Individuals ◽  
Gastric Neoplasia ◽  
H Pylori ◽  
Related Mortality

ObjectivesGastric cancer is strongly associated with Helicobacter pylori (H. pylori). We conducted a previous systematic review and meta-analysis that suggested eradication therapy reduced future incidence of gastric cancer, but effect size was uncertain, and there was no reduction in gastric cancer-related mortality. We updated this meta-analysis, as more data has accumulated. We also evaluated impact of eradication therapy on future risk of gastric cancer in patients having endoscopic mucosal resection for gastric neoplasia.DesignWe searched the medical literature through February 2020 to identify randomised controlled trials (RCTs) examining effect of eradication therapy on subsequent occurrence of gastric cancer in healthy H. pylori-positive adults, and in H. pylori-positive patients with gastric neoplasia undergoing endoscopic mucosal resection. The control arm received placebo or no treatment. Follow-up was for ≥2 years. We estimated the relative risk (RR) number needed to treat (NNT), and evaluated the disability-adjusted life-years (DALYs) gained from screening from the meta-analysis.ResultsWe identified 10 RCTs, seven recruited 8323 healthy individuals, and three randomised 1841 patients with gastric neoplasia. In healthy individuals, eradication therapy reduced incidence of gastric cancer (RR=0.54; 95% CI 0.40 to 0.72, NNT=72), and reduced mortality from gastric cancer (RR=0.61; 95% CI 0.40 to 0.92, NNT=135), but did not affect all-cause mortality. These data suggest that 8 743 815 DALYs (95% CI 5 646 173 to 11 847 456) would be gained if population screening and treatment was implemented globally. In patients with gastric neoplasia, eradication therapy also reduced incidence of future gastric cancer (RR=0.49; 95% CI 0.34 to 0.70, NNT=21). Adverse events were incompletely reported.ConclusionThere is moderate evidence to suggest that H. pylori eradication therapy reduces the incidence of gastric cancer in healthy individuals and patients with gastric neoplasia in East Asian countries. There also appears to be a reduction in gastric cancer-related mortality.

Effects of Helicobacter pylori eradication on gastric cancer incidence in the Japanese population: a systematic evidence review

2021 ◽  
Author(s):  
Yingsong Lin ◽  
Sayo Kawai ◽  
Tae Sasakabe ◽  
Chisato Nagata ◽  
Mariko Naito ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Primary Prevention ◽  
Early Gastric Cancer ◽  
Cohort Studies ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Healthy Individuals ◽  
H Pylori ◽  
Gastric Cancer Patients

Abstract Background In Japan, there are ongoing efforts to shift the gastric cancer prevention and control policy priorities from barium-based screening to Helicobacter pylori (H. pylori)-oriented primary prevention. A comprehensive summary of the evidence regarding the effects of H. pylori eradication on the risk of gastric cancer could inform policy decisions. Methods We conducted a systematic review and meta-analysis of published studies evaluating the effectiveness of H. pylori eradication for the prevention of gastric cancer in otherwise healthy individuals (primary prevention) and early gastric cancer patients (tertiary prevention). Results In total, 19 studies were included. Three moderate-quality observational cohort studies showed that H. pylori eradication may be associated with a decreased risk of gastric cancer in healthy asymptomatic Japanese people. There is moderate certainty regarding the effectiveness of H. pylori eradication in patients with gastrointestinal diseases, such as peptic ulcers. A meta-analysis of 10 observational studies with otherwise healthy individuals (mainly peptic ulcer patients) yielded an overall odds ratio of 0.34 (95% CI: 0.25–0.46). Regarding tertiary prevention, the overall odds ratio for developing metachronous gastric cancer was 0.42 (95% CI: 0.35–0.51) in the eradication group in a meta-analysis of nine studies involving early gastric cancer patients who underwent endoscopic resection. Conclusion H. pylori eradication is effective in preventing gastric cancer in the Japanese population, regardless of symptoms. Well-designed, large cohort studies are warranted to determine the long-term efficacy and safety of H. pylori eradication in the context of reducing the gastric cancer burden through population-based screening and treatment.

Prevalence of Helicobacter pylori infection among blood donors in Saxony-Anhalt, Germany – a region at intermediate risk for gastric cancer

2017 ◽  
Vol 55 (07) ◽  
pp. 653-656 ◽  
Author(s):  
Caspar Franck ◽  
Armin Hoffmann ◽  
Alexander Link ◽  
Christian Schulz ◽  
Kerstin Wuttig ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Blood Donors ◽  
Eradication Therapy ◽  
Surrogate Marker ◽  
University Hospital ◽  
Study Cohort ◽  
Emergency Ward ◽  
Age Related ◽  
H Pylori

Abstract Background In the federal state of Saxony-Anhalt, gastric cancer (GC) incidence ranks among the highest in Germany. Helicobacter pylori prevalence is a surrogate marker for GC risk in a given population. In 2010 we reported an H. pylori seroprevalence of 44.4 % in patients at the emergency ward of the University Hospital of Magdeburg, the capital of Saxony-Anhalt. Our aim is to update these findings in a cohort of healthy blood donors from the same region. Materials and methods The sera of 516 consecutive blood donors (40.1 ± 14.1 years; 286 males and 230 females) were tested for antibodies against H. pylori and CagA. Data on demographics and previous H. pylori eradication therapy were obtained by means of a structured questionnaire. Blood donors with positive serology for H. pylori or CagA and/or history of eradication therapy were classified as H. pylori-positive. Results Overall, 28.9 % of the study cohort were H. pylori-positive. The prevalence was higher in older generations (9 % in 18 – 20 years up to 47 % in 61 – 70 years). In 44.4 % of H. pylori IgG-positive donors, CagA serology was also positive. This proportion was not age-dependent. Study participants with siblings were by trend more often H. pylori-positive (p = 0.066). Conclusion Compared to our previous study in patients at the emergency ward, we found by trend lower age-related H. pylori prevalence rates. In our cohort of healthy blood donors, we confirmed a lower H. pylori prevalence in younger generations.

scholarly journals Two-Way Relationship Between Helicobacter Pylori Infection and Periodontitis: Results from A Systematic Review and Meta-Analysis

2020 ◽  
pp. 1-7
Author(s):  
Felipe Rodolfo ◽  
Silvania Conceição Furtado ◽  
Alessandro Luiz Araújo Bentes Leal ◽  
Any Carolina Cardoso Guimarães Vasconcelos ◽  
Daniel Fernando Pereira Vasconcelos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Helicobacter Pylori ◽  
Meta Analysis ◽  
Current Systematic Review ◽  
Increased Risk ◽  
Statistical Program ◽  
H Pylori ◽  
Ci Calculations ◽  
Review Manager

Aim: Helicobacter pylori (H. pylori) infection and periodontitis have considerable worldwide prevalence once they both present systemic alterations with a possible association between them. Therefore, we have performed this meta-analysis to assess the possible association between H. pylori infection and periodontitis. Material and Methods: A systematic search in the literature was performed for studies published before December 2, 2019 in diverse scientific and educational databases. The data was extracted by two investigators and the statistical analysis was performed by Review Manager statistical program with heterogeneity and Odds Ratio (OR) with 95% of Confidence Intervals (CI) calculations as well as a sensitive analysis to assess the accuracy of the results. The value of P<0.05 was considered as significant. In addition, we performed the analysis of the quality of included studies as well as the evaluation for risk of bias. Results: In overall analysis, H. pylori infection was associated with the risk of periodontitis development (OR = 1.72, CI: 1.47, 2.02, P<0.00001) and the periodontitis was considered as a risk factor for H. pylori infection (OR = 3.21, CI: 2.31, 4.47, P<0.00001). Moreover, the evaluation of dental plaque from patients with periodontitis reveled increased risk of H. pylori infection (OR = 3.46, CI: 2.39, 5.01, P<0.00001). Conclusions: This current systematic review and meta-analysis composed by 12 studies in 7,059 participants showed that H. pylori infection increased significantly the risk of the development of periodontitis and the periodontitis may be a risk for this bacterial infection.

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