Eva Doorakkers1, Jesper Lagergren2, Lars Engstrand2, Nele Brusselaers2. 1. Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (ED, JL, NB); Division of Cancer Studies, King's College London, London, UK (JL); Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden (LE) eva.doorakkers@ki.se. 2. Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (ED, JL, NB); Division of Cancer Studies, King's College London, London, UK (JL); Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden (LE).
Abstract
BACKGROUND: Helicobacter pylori (H. pylori) is associated with an increased risk of gastric adenocarcinoma and gastric mucosa associated lymphoid tissue (MALT) lymphoma and a decreased risk of esophageal adenocarcinoma. We aimed to assess how eradication therapy for H. pylori influences the risk of developing these cancers. METHODS: This was a systematic review and meta-analysis. We searched PubMed, Web of Science, Embase, and the Cochrane Library and selected articles that examined the risk of gastric cancer, MALT lymphoma, or esophageal cancer following eradication therapy, compared with a noneradicated control group. RESULTS: Among 3629 articles that were considered, nine met the inclusion criteria. Of these, eight cohort studies assessed gastric cancer while one randomized trial assessed esophageal cancer. Out of 12 899 successfully eradicated patients, 119 (0.9%) developed gastric cancer, compared with 208 (1.1%) out of 18 654 noneradicated patients. The pooled relative risk of gastric cancer in all eight studies was 0.46 (95% confidence interval [CI] = 0.32 to 0.66, I(2) = 32.3%) favoring eradication therapy. The four studies adjusting for time of follow-up and confounders showed a relative risk of 0.46 (95% CI = 0.29 to 0.72, I(2) = 44.4%). CONCLUSIONS: This systematic review and meta-analysis indicates that eradication therapy for H. pylori prevents gastric cancer. There was insufficient literature for meta-analysis of MALT lymphoma or esophageal cancer.
BACKGROUND:Helicobacter pylori (H. pylori) is associated with an increased risk of gastric adenocarcinoma and gastric mucosa associated lymphoid tissue (MALT) lymphoma and a decreased risk of esophageal adenocarcinoma. We aimed to assess how eradication therapy for H. pylori influences the risk of developing these cancers. METHODS: This was a systematic review and meta-analysis. We searched PubMed, Web of Science, Embase, and the Cochrane Library and selected articles that examined the risk of gastric cancer, MALT lymphoma, or esophageal cancer following eradication therapy, compared with a noneradicated control group. RESULTS: Among 3629 articles that were considered, nine met the inclusion criteria. Of these, eight cohort studies assessed gastric cancer while one randomized trial assessed esophageal cancer. Out of 12 899 successfully eradicated patients, 119 (0.9%) developed gastric cancer, compared with 208 (1.1%) out of 18 654 noneradicated patients. The pooled relative risk of gastric cancer in all eight studies was 0.46 (95% confidence interval [CI] = 0.32 to 0.66, I(2) = 32.3%) favoring eradication therapy. The four studies adjusting for time of follow-up and confounders showed a relative risk of 0.46 (95% CI = 0.29 to 0.72, I(2) = 44.4%). CONCLUSIONS: This systematic review and meta-analysis indicates that eradication therapy for H. pylori prevents gastric cancer. There was insufficient literature for meta-analysis of MALT lymphoma or esophageal cancer.
Authors: Meira Epplein; Wei-Cheng You; Julia Butt; Yang Zhang; Laura H Hendrix; Christian C Abnet; Gwen Murphy; Wei Zheng; Xiao-Ou Shu; Shoichiro Tsugane; You-Lin Qiao; Philip R Taylor; Taichi Shimazu; Keun-Young Yoo; Sue K Park; Jeongseon Kim; Sun Ha Jee; Tim Waterboer; Michael Pawlita; Kai-Feng Pan Journal: Cancer Epidemiol Biomarkers Prev Date: 2018-08-29 Impact factor: 4.254
Authors: Matthew Banks; David Graham; Marnix Jansen; Takuji Gotoda; Sergio Coda; Massimiliano di Pietro; Noriya Uedo; Pradeep Bhandari; D Mark Pritchard; Ernst J Kuipers; Manuel Rodriguez-Justo; Marco R Novelli; Krish Ragunath; Neil Shepherd; Mario Dinis-Ribeiro Journal: Gut Date: 2019-07-05 Impact factor: 23.059