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Meta-analysis: Can Helicobacter pylori Eradication Treatment Reduce the Risk for Gastric Cancer?
- Lorenzo Fuccio, MD;
- Rocco Maurizio Zagari, MD;
- Leonardo Henry Eusebi, MD;
- Liboria Laterza, MD;
- Vincenzo Cennamo, MD;
- Liza Ceroni, MD;
- Diego Grilli, PhD; and
- Franco Bazzoli, MD
Abstract
Background: Helicobacter pylori infection is associated with gastric cancer, but the effect of eradication treatment on gastric cancer risk is not well defined.
Purpose: To determine whether H. pylori eradication treatment can reduce the risk for gastric cancer.
Data Sources: PubMed, EMBASE, Cochrane Library, Google Scholar, and online clinical trial registers through 31 January 2009, without language restrictions.
Study Selection: 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.
Data Extraction: Two authors independently reviewed articles and extracted data.
Data Synthesis: 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).
Limitations: All studies but 1 were performed in Asia. Only 2 assessed gastric cancer incidence, and only 2 were double-blinded.
Conclusion: Helicobacter pylori eradication treatment seems to reduce gastric cancer risk.
Article and Author Information
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Potential Financial Conflicts of Interest: None disclosed.
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Requests for Single Reprints: Franco Bazzoli, MD, Dipartimento di Medicina Interna e Gastroenterologia, Università di Bologna, Policlinico S. Orsola, Via Massarenti 9, 40138 Bologna, Italy; e-mail, franco.bazzoli{at}unibo.it.
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Current Author Addresses: Drs. Fuccio, Zagari, Eusebi, Laterza, Cennamo, Ceroni, and Bazzoli: Dipartimento di Medicina Interna e Gastroenterologia, Università di Bologna, Policlinico S. Orsola, Via Massarenti 9, 40138 Bologna, Italy.
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Dr. Grilli: University of South Florida, 4202 East Fowler Avenue, Tampa, FL 33620.
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