J Dig Cancer Rep.  2020 Dec;8(2):81-90.

Effect of Helicobacter pylori Eradication on the Prevention of Gastric Cancer in the General Population with or without Precancerous Lesions: A Meta-analysis

Affiliations
  • 1Department of Internal Medicine, Seoul National University Bundang Hospital, Bundang, Korea
  • 2Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea

Abstract

We performed a comprehensive meta-analysis on whether Helicobacter pylori (H. pylori) eradication can prevent gastric cancer in individuals with precancerous lesions (chronic atrophic gastritis, intestinal metaplasia, and dysplasia). The studies evaluating the effect of H. pylori eradication on gastric cancer were searched from PubMed, KoreaMed, EMBASE, and Cochrane Library. Subgroup analyses by precancerous lesions, regions and follow-up time were performed. Six randomized clinical trials were included. In the overall population, H. pylori eradication significantly decreased the risk of gastric cancer (risk ratio [RR]=0.56; 95% confidence interval [CI]: 0.41-0.77, p<0.01). Eradication therapy significantly reduced the risk of gastric cancer in Asian and group who followed up more than 10 years (RR=0.51; 95% CI: 0.35-0.73, p<0.01; I2 =0%, p=0.46). However, subgroup analysis according to the precancerous lesions did not show any significant results (p>0.05). In the general population especially in Asian population, H. pylori eradication can reduce the risk of gastric cancer. The effect of the eradication treatment is remarkable upon the long-term follow-up. In contrast, there is insufficient evidence whether the eradication should be recommended for the individuals with precancerous lesions.

Keyword

Atrophic; Gastritis; Helicobacter pylori; Meta-analysis; Precancerous conditions; Stomach neoplasms
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