Table 1.
Key epidemiological studies supporting the link between H. pylori infection and gastric carcinogenesis.
| Author | Study design | Result |
|---|---|---|
| Hansson6 | Case control study | The prevalence of H. pylori seropositivity was significantly higher (p = 0.002) among patients with GC than control patients. The OR was 2.60 (95% CI, 1.35–5.02). |
| Ekstrom4 | Population based case-control study | Based on IgG ELISA and CagA seropositivity the OR for noncardia GC among H. pylori-positive subjects is 21 (95% CI, 8.3–53.4) |
| Uemura7 | Prospective endoscopic follow-up study | GC develops in persons infected with H. pylori but not in uninfected persons. There is an increased risk for GC in patients with severe gastric atrophy, corpus-predominant gastritis or intestinal metaplasia. |
| Wong8 | Prospective, randomized, placebo-controlled, population-based primary prevention study | In H. pylori infected individuals without precancerous lesions, eradication of H. pylori significantly decreases the development of GC. |
| Fuccio9 | Meta-analysis | H. pylori eradication is a primary chemo-preventive strategy of GC. |
| Fukase10 | Multi-centre, open-label, randomized controlled trial | Eradication of H. pylori after endoscopic resection of early GC has the potential to prevent the development of metachronous gastric carcinoma. |
| Ma11 | Prospective randomized controlled trial | GC was diagnosed in 3.0% of subjects who received H. pylori treatment and in 4.6% of those who received placebo (OR = 0.61, 95% CI = 0.38–0.96, p = 0.032). GC deaths occurred among 1.5% of subjects assigned H. pylori treatment and among 2.1% of those assigned placebo (HR of death = 0.67, 95% CI = 0.36–1.28). |
| Li12 | Prospective randomized controlled trial | Treatment was associated with a statistically significant decrease in GC incidence (OR = 0.36; 95% CI = 0.17–0.79) and mortality (HR = 0.26; 95% CI = 0.09–0.79) at ages 55 years and older and with a statistically significant decrease in incidence among those with intestinal metaplasia or dysplasia at baseline (odds ratio = 0.56; 95% CI = 0.34–0.91). |
| Doorakkers13 | Population based cohort study | Eradication treatment for H. pylori seems to counteract the development of gastric adenocarcinoma and noncardia gastric adenocarcinoma in this Western population. |
CI, confidence interval; ELISA, enzyme-linked immunosorbent assay; GC, gastric cancer; HR, hazard ratio; OR, odds ratio.