Table 2:
Summary of studies and patients included
| Study First author’s last name, Publication year (Country), and Study design |
Demographics: Mean Age (SD) or Range in years*; Gender; Ethnicities/Races; |
Settings (pathology database, population based) Biopsy protocol**: | Total subjects (N) Time period |
Subgroups |
|---|---|---|---|---|
| Abangah, 201692 (Iran) Cross-sectional |
Age: 48, Range 21–84 Male: 64.8% Ethnicities: Southern Asia |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum, 2 from body and 1 from incisura |
1000 48 mos. |
- H. pylori positive 80.8% - Smoking history 40.3% - Alcohol consumption 27.9% - Histological predictors: complete GIM 67%, Incomplete GIM 33% - Atrophic Gastritis 7.9% - Dysplasia 1.2% |
| Ajdarkosh, 201478 (Iran) Cross-sectional |
Age: 58 Male: 47.5% Ethnicities: Southern Asia |
Population undergoing endoscopy Biopsy protocol: Biopsies from antrum and body (did not report number of biopsies) |
688 36 mos. |
- H. pylori positive 64.5% |
| Al-Knawy, 199993 (Saudi Arabia) Cross-sectional |
Age: 43, SD 17.6 Male: 53.3% Ethnicities: Western Asia |
Population undergoing endoscopy Biopsy protocol: Biopsies from antrum (did not report number of biopsies) |
778 Not reported |
- H. pylori positive 75.4% - Histological predictors: 1. Complete GIM 85.6 % 2. Incomplete GIM 14.3 |
| Almouradi, 201362 (USA) Retrospective cohort |
Age: Not reported for total population Male: 46.5% Ethnicities/Races: North America/Black, Hispanic, White, and Asian |
Population undergoing endoscopy | 677 7 mos. |
- H. pylori positive 43% - Only 437 patients had gastric biopsies. |
| Aydin, 2017106 (Turkey) Retrospective cohort |
Age: 38.22, SD 14.64, Range 18–88 Male: 44.6% Ethnicities: Western Asia |
Population undergoing endoscopy Biopsy protocol: Biopsies from antrum (did not report number of biopsies) |
682 14 mos. |
- H. pylori positive 69.6% - Atrophic Gastritis 69.6% |
| Brkic, 201787 (Croatia) Cross-sectional |
Age: more than 2/3 were > 50 Male: 47% Ethnicities: Southern Europe |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum and 2 from body |
871 24 mos. |
- H. pylori positive 41% - Atrophic Gastritis 3.5–5% |
| Chang, 200282 (Taiwan) Cross-sectional |
Age: 48.4, Range 30–82 Male: 57.3% Ethnicities: Eastern Asia |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum and 2 from body |
274 2 mos. |
- H. pylori positive 62.4 % |
| Correa, 1990107 (Colombia) Prospective cohort |
Age: Not reported Male: 50% Ethnicities/Races: South America/ Hispanic |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum and 1 from body |
1788 61 mos. |
No data for subgroups reported |
| Craanen, 199194 (Netherlands) Cross-sectional |
Age: 57.8, SD 16.8 Male: Not reported Ethnicities: Western Europe |
Population undergoing endoscopy Biopsy protocol: Biopsies from antrum (did not report number of biopsies) |
533 19 mos. |
- Histological subtypes: 1. Complete GIM (type I) 98.5% 2. Incomplete GIM: type II 77.8% and type III 15.5% |
| Cu, 2000 (Vietnam)108 Cross-sectional |
Age: Range 16–78 Male: 68.9% Ethnicities: South-Eastern Asia |
Population undergoing endoscopy Biopsy protocol: Two biopsies taken from antrum and body |
347 48 mos. |
- H. pylori positive 40.6% |
| Den Hoed, 2011109 (Netherlands) Cross-sectional |
Age: 53.1, Range 17–86 Male: 49.8% Ethnicities: Western Europe |
Population undergoing endoscopy Biopsy protocol: Two biopsies taken from antrum and body |
383 Not reported |
- H. pylori positive 22% - Smoking history: 25% current, 24% ex-smoker - Alcohol consumption: 61% - Atrophic gastritis 9.4% |
| El-Serag, 199963 (USA) Cross-sectional |
Age: 57–58, SD 14–15 Male: Not reported for the total population Ethnicities/Races: North America/White and Hispanic |
Population undergoing endoscopy Biopsy protocol: Two gastric biopsies were obtained from the antrum, corpus, and cardia |
302 Not reported |
- H. pylori positive 43.4% - Atrophic gastritis 9.9% |
| Eriksson, 200889 (Finland) Cross-sectional |
Age: 54, SD 16 Male: 39.9% Ethnicities: Northern Europe |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum and 2 from body |
505 6 mos. |
- H. pylori positive 12.4 % - Histological subtype: 1. Complete GIM 16% 2. Incomplete GIM 8.3% |
| Fennerty, 199264 (USA) Cross-sectional |
Age: 63 Range 24–94 Male: 99.5% Ethnicities/Races: North America/ White 81.6%, Hispanic 13.2%, Native American 2.5%, Black 2.3%, Asian 0.5% |
Population undergoing endoscopy Biopsy protocol: Minimum 2 biopsies from incisura |
440 24 mos. |
- H. pylori positive 45 % |
| Gomez, 201365 (USA) Cross-sectional |
Age: Median 53 Male: 55.7% Ethnicities: North America |
Population undergoing endoscopy | 300 3 mos. |
- H. pylori positive 2% - Family history of stomach cancer 3% - Smoking history: 42% - Alcohol consumption 35% |
| Haroon, 2013110 (Pakistan) Cross-sectional |
Age: 41.3, SD 13.3 Range 16–75 Male: 50% Ethnicities: Southern Asia |
Population undergoing endoscopy Biopsy protocol: Two biopsies taken from antrum and body |
375 6 mos. |
- H. pylori positive 47% - Atrophic gastritis 9.6% - Dysplasia1.3% |
| Haziri, 2017111 (Kosovo) Cross-sectional |
Age: most subjects 40–49 Male: 60.2% Ethnicities: Southern Europe |
Population undergoing endoscopy Biopsy protocol: Multiple biopsies from antrum and body |
802 Not reported |
- H. pylori positive 59.7% - Atrophic Gastritis 17.6% |
| Hong, 201484 (China) Cross-sectional |
Age: 45.8, SD 12.1 Male: 72.9% Ethnicities: Eastern Asia |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum, 2 from body and 1 from incisura |
9297 116 mos. |
- Dysplasia 2.3% |
| Hsu, 2007112 (Taiwan) Prospective cohort |
Age: 53.6 Male: 66.2% Ethnicities: Eastern Asia |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum and 2 from body |
1225 96 mos. |
- H. pylori positive 50.4% - Smoking history 27.8% - Alcohol consumption 13.1% |
| Huang, 2012113 (China) Cross-sectional |
Age: 44.7, SD 13.5 Male: 60% Ethnicities: Eastern Asia |
Population undergoing endoscopy Biopsy protocol: Two biopsies taken from antrum |
406 56 mos. |
- H. pylori positive 24.1% |
| Ibrisim, 2008114 (Turkey) Cross-sectional |
Age: 46.36, SD 11.4 Male; 46.7% Ethnicities: Western Asia |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum, 2 from body and 1 from incisura |
289 35 mos. |
- H. pylori positive 39.1% - Histological predictors: 1. Complete GIM 6.9% 2. Incomplete GIM 19.4 - Atrophic gastritis 25.6% - Dysplasia 3.8% |
| Imai, 2013115 (Japan) Cross-sectional |
Age: Not reported Male: 50% Ethnicities/Races: Eastern Asia |
Autopsy study Biopsy protocol: Stomachs from autopsies |
937 84 mos. |
No subgroups |
| Isajevs, 201485 (Lithuania) Cross-sectional |
Age: Not reported Male: Not reported Ethnicities: Northern Europe |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum, 2 from body and 1 from incisura |
835 Not reported |
- H. pylori positive 57.8% - Atrophic Gastritis 33.4% - OLGA stages: stage 0 = 556, stage I =184, stage II = 70, stage III = 20, stage IV = 5 - OLGIM stage: stage 0 = 591, stage I =155, stage II = 66, stage III = 19, stage IV = 4 |
| Jedrychowski, 201081 (Poland) Cross-sectional |
Age: Not reported Male: 58.5% Ethnicities: Eastern Europe |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum |
1,290 Not reported |
No data for subgroups reported |
| Jiang, 201734 (China) Cross-sectional |
Age: 50.98, SD 13.3 Male: 50% Ethnicities: Eastern Asia |
Population undergoing endoscopy Biopsy protocol: One biopsy from antrum (3 cm from the pylorus) |
28,745 Not reported |
- Atrophic gastritis 8.54% - Dysplasia 5.81% |
| Joo, 201379 (Korea) Cross-sectional |
Age: 48.7, SD 11.3, Range 15–98 Male: 58.6% Ethnicities: Eastern Asia |
Population undergoing endoscopy | 4,023 12 mos. |
- H. pylori positive 59.8% - Family history of stomach cancer 11.4% - Smoking history 21.9 % - Alcohol consumption 61.8% - Atrophic gastritis 40.7% |
| Kang, 201535 (Korea) Cross-sectional |
Age: 56.23, SD 9.76, Range 40–93 Male: 43.62% Ethnicities: Eastern Asia |
Medical records of patients who underwent endoscopy | 40,821 78 mos. |
- Atrophic gastritis 27.97% |
| Kim, 200814 (Korea) Prospective cohort |
Age: 46.7 Male: 79.2% Ethnicities: Eastern Asia |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum and 2 from body |
1,790 72 mos. |
- H. pylori positive 81.2% |
| Lahner, 2014116 (Italy) Cross-sectional |
Age: 58, Range 50–65 Male: 36.6% Ethnicities: Southern Europe |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum, 2 from body and 1 from incisura |
979 Not reported |
- H. pylori positive 34% - Family history of stomach cancer 11.6% - Smoking history 35.7% - Alcohol consumption 32.5% - Atrophic Gastritis 10% |
| Mansour-Ghanaei, 201276 (Iran) Cross-sectional |
Age: 43.45, SD 10.6 Gender: 49.4% Ethnicities: Southern Asia |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum, 2 from body and 1 from incisura |
1095 36 mos. |
- H. pylori positive 76.6% - Family history of stomach cancer 46% - Atrophic gastritis 4.3% - Dysplasia 2% |
| Micu, 2010117 (Romania) Cross-sectional |
Age: 57, Range 16–89 Male: 48.1% Ethnicities: Eastern Europe |
Population undergoing endoscopy Biopsy protocol: Biopsies were taken from antrum and body (did not report number of biopsies) |
3096 49 mos. |
- H. pylori positive 46.1% |
| Nam, 201497 (Korea) Cross-sectional |
Age: 48.2, SD 10.8, Range 21–68 Male: 49.2% Ethnicities: Eastern Asia |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum and 2 from body |
632 20 mos |
- H. pylori positive 59% - Family history of stomach cancer 10.6% - Smoking history 23.4 % - Alcohol consumption 60.3% |
| Nasser, 2015118 (Lebanon) Cross-sectional |
Age: Median 50, Range 20–87 Male: 50% Ethnicities: Western Asia |
Population undergoing endoscopy | 300 27 mos. |
- H. pylori positive 52% - Smoking history: 42% - Alcohol consumption 20.7% |
| Niknam, 201596 (Iran) Cross-sectional |
Age: 39, SD 15 Male: 30% Ethnicities: Southern Asia |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum and 2 from body |
1,376 Not reported |
- H. pylori positive 76.5% - Histological subtypes: 1. Complete GIM 2.6% 2. Incomplete GIM 0.4% |
| Olmez, 2015119 (Turkey) Retrospective cohort |
Age: 57, SD 15, Range 17–98 Male: 59.5% Ethnicities: Western Asia |
Population undergoing endoscopy | 4,050 52 mos. |
- Histological subtypes: 1. Complete GIM (type I) 8.2% 2. Incomplete GIM: type II 32% and type III 38% |
| Ozdil, 2010120 (Turkey) Retrospective cohort |
Age: 45.97, SD 15.15, Range 18–94 Male: 40% Ethnicities: Western Asia |
Population undergoing endoscopy Biopsy protocol: Biopsies from antrum and body (did not report number of biopsies) |
3,301 23mos |
- H. pylori positive 71.3% |
| Petersson, 200274 (Sweden) Cross-sectional |
Age: 60, Range 35–85 Male: 54.5% Ethnicities: Northern Europe |
Population undergoing endoscopy Biopsy protocol: Three biopsies from antrum and 3 from body |
502 Not reported |
- H. pylori positive 40% - Histological subtypes: 1. Complete GIM (type I) 15% 2. Incomplete GIM: type II 64% and type III 21% - Atrophic gastritis 48$ - Pernicious anemia 5.4 % |
| Plummer, 200772, 75 (Venezuela) RCT |
Age: Not reported for the total population Male: 47% Ethnicities/Races: South America (Hispanic) |
Population undergoing endoscopy Biopsy protocol: Three biopsies from antrum and 1 from body |
2,200/2131 36 mos. |
- H. pylori/cagA status: cagA(+) 40%, cagA(-) 44%, uninfected 16%. - Histological subtype: 1. Complete GIM (type I) 70.4% 2. Incomplete GIM: type II 15.2% and type III 14.3% - Atrophic gastritis15% - Dysplasia 6% |
| Saragih, 2007121 (Indonesia) Retrospective cohort |
Age: Not reported Male: Not reported Ethnicities: South-Eastern Asia |
Population undergoing endoscopy Biopsy protocol: Biopsies were taken from antrum, body and incisura (did not report number of biopsies) |
2903 96 mos. |
- H. pylori positive 9% |
| Sobala, 199386 (UK) Cross-sectional |
Age: median 49, Range 18–88 Male: 60.6% Ethnicities: Northern Europe |
Population undergoing endoscopy Biopsy protocol: Two biopsies taken from antrum |
350 Not reported |
- H. pylori positive 63.1% - Histologic subtype: 1. Complete GIM (type I) 61% 2. Incomplete GIM: type II 64%, type III 6%, and multiple 29% |
| Song, 201510 (Sweden) Cross-sectional |
Age: 56 Male: 44.5% Ethnicities: Northern Europe |
Patients in a national database who underwent endoscopy with biopsies | 342,297 264 mos. |
- Atrophic gastritis 4.2% - Dysplasia 0.6% |
| Song, 201780 (Korea) Cross-sectional |
Age: 52.76, SD 10.74 Male: 48.5% Ethnicities: Eastern Asia |
Population undergoing endoscopy | 662 91 mos. |
- H. pylori positive 61.5% - Family history of stomach cancer 10.3% - Smoking history 39.2 % - Alcohol consumption 71.4% - Atrophic gastritis 29% |
| Sonnenberg, 201536 (USA) Cross-sectional |
Age: Not reported Male: 38% Ethnicities: North America |
Patients in a national pathology database who underwent endoscopy | 895,323 72 mos. |
- H. pylori positive 10.6% - Atrophic gastritis 12.8% |
| Tsukanov, 2011122 (Siberia) Cross-sectional |
Age: 36.1(male), 42.3(female) Male: 47.5% Ethnicities: Eastern Europe 32.4% Eastern Asia 67.6% |
Population undergoing endoscopy Biopsy protocol: One biopsy from antrum, 1 from body and 1 from incisura |
2129 Not reported |
- H. pylori positive 94.1% |
| Ucuncu, 2016123 (Turkey) Cross-sectional |
Age: 43.70, Range 18–65 Male: 39.5% Ethnicities: Western Asia |
Population undergoing endoscopy Biopsy protocol: Biopsies were taken from antrum and body (did not report number of biopsies) |
3096 24 mos. |
- H. pylori positive 28.4% - Smoking history 18.8% - Alcohol history 1.3% - Atrophic gastritis 5.8% |
| Wang, 1998124 (Taiwan) Cross-sectional |
Age: 44.3, SD 11.1 Male: 55.2% Ethnicities: Eastern Asia |
Population undergoing endoscopy Biopsy protocol: Four biopsies from antrum and 4 from body |
302 Not reported |
- H. pylori positive 61.3% |
| Wang, 201783 (China) Cross-sectional |
Age: 53.1, SD 11.8 Male: 42.3% Ethnicities: Eastern Asia |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum, 2 from body and 1 from incisura |
331 14 mos. |
- H. pylori positive 43.2% - Family history of stomach cancer 6.34% - Smoking History: 13.6% current, 26.6% ex-smoker - Alcohol consumption: 33.5% current, 42.9% ex-drinker - Atrophic gastritis 46.5% - Pepsinogen positive (PG I level ≤70 ng/mL and PG I/II ≤7) 5.4% |
| Whiting, 2002125 (UK) Prospective cohort |
Age: Not reported Male: Not reported Ethnicities: Northern Europe |
Population undergoing endoscopy | 1753 120 mos. |
- Atrophic gastritis 1.6% - Dysplasia 0.9% |
| Xia, 200088 (Australia) Cross-sectional |
Age: 52.1, Range 17–85 Male: 48.5% Ethnicities/Races: Australia |
Population undergoing endoscopy Biopsy protocol: Two biopsies from antrum, 2 from body and 1 from incisura |
268 Not reported |
- H. pylori positive 42% - Atrophic gastritis 19% |
| Yee, 2009126 (Hong Kong) Retrospective cohort |
Age: 45.4 Range 14–89 Male: 39% Ethnicities: Eastern Asia |
Population undergoing endoscopy Biopsy protocol: Biopsies were taken from antrum and body (did not report number of biopsies) |
1751 72 mos. |
- H. pylori positive 45% |
| You, 199390 (China) Cross-sectional |
Age: Range 35–64 Male: 52.7% Ethnicities: Eastern Asia |
Population undergoing endoscopy Biopsy protocol: Seven to eight biopsies divided by antrum, body and incisura |
3400 Not reported |
- Atrophic gastritis 44.8% - Dysplasia 20.1% |
| You, 2006127 (China) RCT |
Age: 46.8 Male: 50% Ethnicities: Eastern Asia |
Population undergoing endoscopy Biopsy protocol: Four biopsies from antrum, 2 from body and 1 from incisura |
3411/3344 12 mos. |
- H. pylori positive 67.1% - Atrophic gastritis 45.2% - Dysplasia 13.6% |
| Zabaleta, 201166 (USA) Cross-sectional |
Age: 48–56, SD 11–12 Male: 20–36% Ethnicities/Races: North America/Black 63.4%, White 36.6% |
Population undergoing endoscopy Biopsy protocol: One biopsy from antrum, body and incisura |
569 Not reported |
- H. pylori positive 32% - Smoking history 34.4%% - Dysplasia 0.4% |
| Summary of studies that only included H. pylori infected patients only or studies that only included patients with first degree family history of gastric cancer | ||||
| Chen, 200167 (China/Netherlands) Cross-sectional |
Age: Chinese 40.9; Dutch 49.7 Male: Chinese 57%; Dutch 58.2% Ethnicities: Eastern Asia (Chinese) 57.0%; Western Europe (Dutch) 58.2% |
H. pylori positive patients that had endoscopy Biopsy protocol: Four biopsies from antrum, and 4 from body |
526 Not reported |
- Atrophic gastritis: Chines 52%; Dutch 42% |
| Eidt, 199468 (Germany) Cross-sectional |
Age: 51.4 Male: 60% Ethnicities: Western Europe |
H. pylori positive patients that had endoscopy Biopsy protocol: Two biopsies from antrum |
2692 24 mos |
No data for subgroups reported |
| Guarner, 200169 (Mexico) Cross-sectional |
Age: 51.8; SD 9.5 Male: Not reported Ethnicities: Central America |
H pylori positive patients that had endoscopy. Biopsy protocol: 3 from the antrum, 1 from the incisura angularis, and 3 from the corpus. |
368 Not reported |
- Atrophic gastritis 62% |
| Lee, 201370 (Taiwan) Prospective cohort |
Age: 49.2, SD 12.8 Male: 45.8% Ethnicities: Eastern Asia |
H pylori positive patients that had endoscopy. Biopsy protocol: Biopsies from antrum and body (did not report number of biopsies) |
4121/1762 48 mos. |
- Atrophic gastritis 59.9% - Dysplasia 0.3% |
| Leodolter, 201371 (Germany) Retrospective cohort |
Age: 54.8 Male: 53.2% Ethnicities: Western Europe |
H. pylori positive patients that had endoscopy Biopsy protocol: Two biopsies from antrum, and 2 from body |
845 48 mos. |
- Atrophic gastritis 3.2% |
| Leung, 200577 (China) Cross-sectional |
Age: Median 24; Range 8–66 Male: 47% Ethnicities: Eastern Asia |
Patients with first degree family history of gastric cancer that had endoscopy Biopsy protocol: Four biopsies from antrum, and 4 from body |
270 31 mos. |
- H. pylori positive 59.6% - Smoking history 19.6% - Alcohol consumption 33% |
| Sadjadi, 201415 (Iran) Prospective cohort |
Age: 53.1, SD 9.9 Male: 49.1% Ethnicities: Southern Asia |
H. pylori positive patients that had endoscopy Biopsy protocol: Two biopsies from antrum, 2 from body and 1 from incisura |
928 121.8 mos. |
- Family history of stomach cancer 20.7% - Smoking history 39.1% - Alcohol consumption 4.7% - Dietary intake: high salt (> 6 grams) 81.1% |
*
Ages are means with standard deviation unless otherwise specified.