H pylori eradication therapy for prevention of gastric cancer

Takeaway

• Helicobacter pylori (H pylori) eradication therapy reduces the incidence of gastric cancer and cancer-related mortality in both healthy individuals and patients with gastric neoplasia in East-Asian countries.

Why this matters

• Findings support screening for, and treatment of, H. pylori in healthy individuals and in patients with gastric neoplasia, as a means of reducing the future incidence of gastric cancer.

Study design

• 7 randomised controlled trials including 8323 healthy individuals and 3 trials including 1841 patients with gastric neoplasia met eligibility criteria.
• Funding: None.

Key results

• In healthy individuals, eradication therapy reduced the incidence of gastric cancer (risk ratio [RR], 0.54; 95% CI, 0.40-0.72) and cancer-related mortality; and but did not affect all-cause mortality (RR, 0.61; 95% CI, 0.40-0.92).
• In patients with gastric neoplasia, eradication therapy reduced the incidence of future gastric cancer (RR, 0.49; 95% CI, 0.34-0.70).
• Adverse events were incompletely reported by the majority of trials.

Limitations

• Only one trial was conducted outside East Asia.