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Meta-Analysis
. 2023 Aug 19;23(1):543.
doi: 10.1186/s12879-023-08504-5.

The global prevalence of gastric cancer in Helicobacter pylori-infected individuals: a systematic review and meta-analysis

Maryam Shirani #  1 , Reza Pakzad #  2   3 , Mohammad Hossein Haddadi  4 , Sousan Akrami  5   6 , Arezoo Asadi  7 , Hossein Kazemian  4 , Melika Moradi  6 , Vahab Hassan Kaviar  8 , Abolfazl Rafati Zomorodi  9 , Saeed Khoshnood  3   4 , Mahnaz Shafieian  10 , Ronia Tavasolian  11 , Mohsen Heidary  12   13 , Morteza Saki  14
Affiliations
Meta-Analysis

The global prevalence of gastric cancer in Helicobacter pylori-infected individuals: a systematic review and meta-analysis

Maryam Shirani et al. BMC Infect Dis. .

Abstract

Background: Helicobacter pylori is a gastrointestinal pathogen that infects around half of the world's population. H. pylori infection is the most severe known risk factor for gastric cancer (GC), which is the second highest cause of cancer-related deaths globally. We conducted a systematic review and meta-analysis to assess the global prevalence of GC in H. pylori-infected individuals.

Methods: We performed a systematic search of the PubMed, Web of Science, and Embase databases for studies of the prevalence of GC in H. pylori-infected individuals published from 1 January 2011 to 20 April 2021. Metaprop package were used to calculate the pooled prevalence with 95% confidence interval. Random-effects model was applied to estimate the pooled prevalence. We also quantified it with the I2 index. Based on the Higgins classification approach, I2 values above 0.7 were determined as high heterogeneity.

Results: Among 17,438 reports screened, we assessed 1053 full-text articles for eligibility; 149 were included in the final analysis, comprising data from 32 countries. The highest and lowest prevalence was observed in America (pooled prevalence: 18.06%; 95% CI: 16.48 - 19.63; I2: 98.84%) and Africa (pooled prevalence: 9.52%; 95% CI: 5.92 - 13.12; I2: 88.39%). Among individual countries, Japan had the highest pooled prevalence of GC in H. pylori positive patients (Prevalence: 90.90%:95% CI: 83.61-95.14), whereas Sweden had the lowest prevalence (Prevalence: 0.07%; 95% CI: 0.06-0.09). The highest and lowest prevalence was observed in prospective case series (pooled prevalence: 23.13%; 95% CI: 20.41 - 25.85; I2: 97.70%) and retrospective cohort (pooled prevalence: 1.17%; 95% CI: 0.55 - 1.78; I 2: 0.10%).

Conclusions: H. pylori infection in GC patients varied between regions in this systematic review and meta-analysis. We observed that large amounts of GCs in developed countries are associated with H. pylori. Using these data, regional initiatives can be taken to prevent and eradicate H. pylori worldwide, thus reducing its complications.

Keywords: Gastric cancer; Helicobacter pylori; Infection; Meta-analysis; Prevalence; Systematic review.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of study selection
Fig. 2
Fig. 2
Forest plot of prevalence of gastric cancer in Helicobacter pylori positive patients
Fig. 3
Fig. 3
Pooled prevalence with 95% confidence interval [CI] and heterogeneity indexes of gastric cancer in Helicobacter pylori positive patients based on type of the design and continents places. The diamond mark illustrates the pooled prevalence and the length of the diamond indicates the 95% CI
Fig. 4
Fig. 4
Association between Pooled prevalence of gastric cancer in Helicobacter pylori positive patients with age (A) and publication year (B) by means of meta-regression. The size of circles indicates the precision of each study. There is a positive significant association with respect to the pooled prevalence with age
See this image and copyright information in PMC

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