Abstract
Background: Helicobacter pylori (H. pylori) is associated with an increased risk of gastric adenocarcinoma and gastric mucosa associated lymphoid tissue (MALT) lymphoma, and a seemingly decreased risk of oesophageal adenocarcinoma. We aimed to assess how eradication therapy for H. pylori influences the risk of developing these cancers.
Methods: This was a systematic review and meta-analysis. We searched PubMed, Web of Science, Embase and the Cochrane Library and selected articles that examined the risk of gastric cancer, MALT lymphoma or oesophageal cancer following eradication therapy, compared to a non-eradicated control group.
Results: Among 3629 articles that were considered, 9 met the inclusion criteria. Of these, 8 cohort studies assessed gastric cancer, while 1 randomized trial assessed oesophageal cancer. Out of 12,899 successfully eradicated patients, 119 (0.9%) developed gastric cancer, compared to 208 (1.1%) out of 18,654 non-eradicated patients. The pooled relative risk of gastric cancer in all 8 studies was 0.46 (95% confidence interval 0.32-0.66, I2 32.3%) favouring eradication therapy. The 4 studies adjusting for time of follow-up and confounders showed a relative risk of 0.46 (95% confidence interval 0.29-0.72, I2 44.4%).
Conclusion: This systematic review and meta-analysis indicates that eradication therapy for H. pylori prevents gastric cancer. There was insufficient literature for meta-analysis of MALT lymphoma or oesophageal cancer.
