Meta-analysis: can Helicobacter pylori eradication treatment reduce the risk for gastric cancer?
BACKGROUND
Helicobacter pylori infection is associated with gastric cancer, but the effect of eradication treatment on gastric cancer risk is not well defined.


OBJECTIVE
To determine whether H. pylori eradication treatment can reduce the risk for gastric cancer.


METHODS
PubMed, EMBASE, Cochrane Library, Google Scholar, and online clinical trial registers through 31 January 2009, without language restrictions.


METHODS
Randomized trials that compared eradication treatment with no treatment in H. pylori-positive patients and that assessed gastric cancer or progression of preneoplastic lesions during follow-up.


METHODS
Two authors independently reviewed articles and extracted data.


RESULTS
Seven studies met inclusion criteria, 1 of which was excluded from pooled analysis because of clinical and methodological heterogeneity. All studies were performed in areas with high incidence of gastric cancer, mostly in Asia. Overall, 37 of 3388 (1.1%) treated patients developed gastric cancer compared with 56 of 3307 (1.7%) untreated (control) participants. In a pooled analysis of 6 studies with a total of 6695 participants followed from 4 to 10 years, the relative risk for gastric cancer was 0.65 (95% CI, 0.43 to 0.98).


CONCLUSIONS
All studies but 1 were performed in Asia. Only 2 assessed gastric cancer incidence, and only 2 were double-blinded.


CONCLUSIONS
Helicobacter pylori eradication treatment seems to reduce gastric cancer risk.
Fuccio
Lorenzo
L
University of Bologna, Bologna, Italy.
Zagari
Rocco Maurizio
RM
Eusebi
Leonardo Henry
LH
Laterza
Liboria
L
Cennamo
Vincenzo
V
Ceroni
Liza
L
Grilli
Diego
D
Bazzoli
Franco
F
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology / Q000517:prevention & control; D012107:Research Design / Q000592:standards; D012307:Risk Factors; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000473:pathology / Q000517:prevention & control*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents