The Global Prevalence of Gastric Cancer in Helicobacter Pylori-infected Individuals: a Systematic Review and Meta-analysis

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2023 Aug 19

PMID 37598157

Authors

Maryam Shirani

Reza Pakzad

Mohammad Hossein Haddadi

Sousan Akrami

Arezoo Asadi

Hossein Kazemian

Melika Moradi

Vahab Hassan Kaviar

Abolfazl Rafati Zomorodi

Saeed Khoshnood

Mahnaz Shafieian

Ronia Tavasolian

Mohsen Heidary

Morteza Saki

Affiliations

Soon will be listed here.

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 I index. Based on the Higgins classification approach, I 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; I: 98.84%) and Africa (pooled prevalence: 9.52%; 95% CI: 5.92 - 13.12; I: 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.

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