Cancer Res Treat.  2021 Jul;53(3):744-753. 10.4143/crt.2020.610.

Population Attributable Fraction of Helicobacter pylori Infection–Related Gastric Cancer in Korea: A Meta-Analysis

• Park Y
• Ki M

• KMID: 2518398
• DOI: http://doi.org/10.4143/crt.2020.610

Abstract

Purpose
This study aimed to determine the proportion of gastric cancer attributable to Helicobactor pylori in the Korean population. Infection with H. pylori has been recognized as the most significant risk factor for gastric cancer. In Korea, gastric cancer is the most common cancer that accounted for 13.3% of all cancers in 2016. In particular, men are most commonly diagnosed with gastric cancer; the age-standardized incidence rate in men is 49.6 per 100,000, which is more than twice the incidence in women.
Materials and Methods
The population attributable fraction (PAF) was calculated as a function of the relative risk (RR) of gastric cancer associated with H. pylori infections. To estimate PAF of gastric cancer due to H. pylori, the prevalence of H. pylori infections was extrapolated for the year of 1990 and a pooled RR was obtained by conducting a meta-analysis of studies recently published in Korea.
Results
The estimated prevalence of H. pylori was 76.4% in men and 71.9% in women. The RRs (95% confidence interval) pooled from case-control studies using a random effects model was 1.69 (1.29-2.22) for overall gastric cancer and 2.17 (1.04-4.55) for non-cardia gastric cancer. Using the RR for overall gastric cancer, the estimated PAFs due to H. pylori were 34.5% in men and 33.2% in women.
Conclusion
The occurrence of gastric cancer in Koreans may be affected by other risk factors in addition to H. pylori infection, which may contribute to increasing baseline risk for gastric cancer.

Keyword

Stomach neoplasms; Population attributable fraction; Meta-analysis; Korea

Figure

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  Fig. 1 Back extrapolation to estimate the Helicobacter pylori prevalence in 1990 among Koreans. a)Estimates extrapolated backward using the reported H. pylori prevalences in 1998, 2005, 2011, and 2016.

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  Fig. 2 Summary effect size of Helicobacter pylori infection on overall, non-cardia, and cardia gastric cancer (GC) among Koreans: a meta-analysis [13–23]. CI, confidence interval; OR, odds ratio.

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  Fig. 3 Population attributable fraction (PAF, %) for gastric cancer (GC) due to Helicobacter pylori infection in Koreans. a)Estimates extrapolated backward using the reported H. pylori prevalences in 1998, 2005, 2011, and 2016.

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