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Meta-Analysis
. 2021 Jul 1;51(7):1158-1170.
doi: 10.1093/jjco/hyab055.

Effects of Helicobacter pylori eradication on gastric cancer incidence in the Japanese population: a systematic evidence review

Yingsong Lin  1 , Sayo Kawai  1 , Tae Sasakabe  1 , Chisato Nagata  2 , Mariko Naito  3 , Keitaro Tanaka  4 , Yumi Sugawara  5 , Tetsuya Mizoue  6 , Norie Sawada  7 , Keitaro Matsuo  8   9 , Tetsuhisa Kitamura  10 , Mai Utada  11 , Hidemi Ito  12   13 , Taichi Shimazu  7 , Shogo Kikuchi  1 , Manami Inoue  7 ; Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan
Affiliations
Meta-Analysis

Effects of Helicobacter pylori eradication on gastric cancer incidence in the Japanese population: a systematic evidence review

Yingsong Lin et al. Jpn J Clin Oncol. .

Erratum in

Abstract

Background: In Japan, there are ongoing efforts to shift the gastric cancer prevention and control policy priorities from barium-based screening to Helicobacter pylori (H. pylori)-oriented primary prevention. A comprehensive summary of the evidence regarding the effects of H. pylori eradication on the risk of gastric cancer could inform policy decisions.

Methods: We conducted a systematic review and meta-analysis of published studies evaluating the effectiveness of H. pylori eradication for the prevention of gastric cancer in otherwise healthy individuals (primary prevention) and early gastric cancer patients (tertiary prevention).

Results: In total, 19 studies were included. Three moderate-quality observational cohort studies showed that H. pylori eradication may be associated with a decreased risk of gastric cancer in healthy asymptomatic Japanese people. There is moderate certainty regarding the effectiveness of H. pylori eradication in patients with gastrointestinal diseases, such as peptic ulcers. A meta-analysis of 10 observational studies with otherwise healthy individuals (mainly peptic ulcer patients) yielded an overall odds ratio of 0.34 (95% CI: 0.25-0.46). Regarding tertiary prevention, the overall odds ratio for developing metachronous gastric cancer was 0.42 (95% CI: 0.35-0.51) in the eradication group in a meta-analysis of nine studies involving early gastric cancer patients who underwent endoscopic resection.

Conclusion: H. pylori eradication is effective in preventing gastric cancer in the Japanese population, regardless of symptoms. Well-designed, large cohort studies are warranted to determine the long-term efficacy and safety of H. pylori eradication in the context of reducing the gastric cancer burden through population-based screening and treatment.

Keywords: Helicobacter pylori eradication; evidence; gastric cancer; prevention; systematic review.

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