A systematic review and meta-analysis of the role of eradication in preventing gastric cancer.

BACKGROUND

Increasing evidence has suggested that () eradication might prevent the development of gastric cancer (GC). This systematic review and meta-analysis aimed to better explore the role of eradication in preventing GC, with particular reference to patients with precancerous lesions at baseline histology.

METHODS

Searches for human studies were performed through October 2016 and risk ratios (RRs), were obtained. Heterogeneity between studies was estimated using the Cochran Q test and values, whereas the possibility of publication bias was estimated with funnel plots. Additionally, we performed subgroup and sensitivity analyses.

RESULTS

In 26 studies suitable for meta-analysis (10 randomized controlled trials and 16 cohort studies) 52,363 subjects were included. The risk of GC among patients in whom was successfully eradicated was significantly lower than that among controls: pooled RRs [95% CI] 0.56 [0.48-0.66], Z= -7.27, P=0.00001. This finding applied separately for randomized controlled trials (0.65 [0.51-0.84], Z= -3.33, P=0.0009) and for cohort studies (0.51 [0.42-0.62], Z= -6.63, P=0.00001). Concerning eradication in patients with precancerous lesions, subgroup analyses showed that patients with non-atrophic or atrophic gastritis benefited from eradication for the risk of GC development, whereas those with intestinal metaplasia or dysplasia did not.

CONCLUSION

eradication is associated with a significantly lower risk of GC; this finding has significant implications for the prevention of this cancer. The benefit is maximized when eradication is applied at early stages of the infection.