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, according to investigators.
These findings suggest that decreasing H. pylori prevalence does indeed reduce rates of gastric cancer, although large-scale clinical trials are needed to solidify confidence in this apparent relationship, reported lead author Yi Chun Chen, PhD, of National Taiwan University, Taipei, and colleagues.
“Eradication of H. pylori infection heals chronic active gastritis and peptic ulcer disease and reduces the risk of peptic ulcer bleeding in aspirin users and the risk of gastric cancer in infected individuals,” the investigators wrote in Gastroenterology. “However, whether reduction of the prevalence of H. pylori is associated with a reduction of the incidence of gastric cancer at the population level remains uncertain.”
According to several previous meta-analyses, the global rate of H. pylori infection has been in a downtrend, but Dr. Chen and colleagues pointed out several limitations of these publications, including scarcity of recent data, insufficiently representative data, inconsistent diagnostic methods, and lack of adjustment for socioeconomic status.
“We therefore conducted this comprehensive systematic review and meta-analysis, including healthy individuals recruited in hospital-based studies, to provide an updated global prevalence and the secular trend of H. pylori infection,” the investigators wrote, noting that they leveraged meta-regression analysis to “identify factors affecting heterogeneity of the prevalence,” and concurrently evaluated the corresponding global incidence of gastric cancer.
Their dataset, which included 1,748 articles from 111 countries, suggested that the global rate of H. pylori is indeed in a downtrend.
From a crude global prevalence of 52.6% prior to 1990, the rate of H. pylori decreased to 43.9% among adults in 2015-2022, but was “still as high as” 35.1% among children and adolescents in the same 2015-2022 period. Multivariate regression analysis showed that prevalence decreased significantly, by 15.9%, among adults, but not in children and adolescents.
“The significant reduction of H. pylori prevalence in adults can be explained by the improvement of socioeconomic status, cleaner water supply, better sanitation and hygiene status, and widening of indication for eradication therapy,” Dr. Chen and colleagues wrote. “The higher prevalence in adults than in children/adolescents is explained by the cohort effect because most H. pylori infection is acquired in childhood.”
Global incidence of gastric cancer among both male and female individuals declined approximately in parallel with decreasing prevalence of H. pylori. Rates of gastric cancer decreased most in high-incidence countries such as Brazil, Japan, and China.
“These studies collectively provide evidence for the causal association of H. pylori infection and gastric cancer and that elimination of this bacterium can prevent the development of gastric cancer,” the investigators wrote.
Still, more work is needed.
“Future prospective studies should be conducted to confirm whether public health interventions or mass screening and eradication of H. pylori infection to reduce its prevalence may reduce the incidence of gastric cancer at population level,” Dr. Chen and colleagues concluded. “Besides, it is also important to consider the potential adverse consequences of H. pylori eradication, such as emergence of antibiotic resistance. The benefit-to-harm ratio and cost-effectiveness should also be taken into account.”
The study was funded by the National Taiwan University Hospital, the Taiwan Ministry of Science and Technology, the Taiwan Ministry of Health and Welfare, and others. The investigators disclosed no conflicts of interest.
Chen et al.’s study establishes a connection between the global decline in H. pylori infection rates and the decrease in gastric cancer cases, analyzing data from 1,748 articles across 111 countries. It highlights a significant drop in adult H. pylori prevalence from 52.6% before 1990 to 43.9% between 2015 and 2022, crediting improvements in socioeconomic conditions, water quality, and sanitation, along with targeted eradication efforts. This emphasizes the critical role of public health measures in reducing H. pylori infections and, consequently, gastric cancer risks, showcasing the success of eradication campaigns and widespread screening.
Nevertheless, the research advises caution regarding the widespread elimination of H. pylori due to the risk of antibiotic resistance. It advocates for a measured evaluation of the pros and cons, as well as the cost-effectiveness of such interventions. The authors call for additional large-scale clinical trials to verify these results and improve public health tactics.
The findings indicate that precise public health actions can greatly influence disease prevention, underlining the necessity of well-informed policies backed by ongoing clinical research and trials. Such an informed approach is essential to confirm that the advantages of eradication surpass the potential dangers, particularly considering the growing concern over antibiotic resistance. This study lays the groundwork for effective gastric cancer prevention strategies and emphasizes the ongoing need for research to shape sound public health policies and actions.
Li-Ju Chen, PhD, is a postdoctoral researcher in the Division of Clinical Epidemiology and Aging Research at the German Cancer Research Center, Heidelberg, Germany. She declared no conflicts of interest in regard to this review.
Chen et al.’s study establishes a connection between the global decline in H. pylori infection rates and the decrease in gastric cancer cases, analyzing data from 1,748 articles across 111 countries. It highlights a significant drop in adult H. pylori prevalence from 52.6% before 1990 to 43.9% between 2015 and 2022, crediting improvements in socioeconomic conditions, water quality, and sanitation, along with targeted eradication efforts. This emphasizes the critical role of public health measures in reducing H. pylori infections and, consequently, gastric cancer risks, showcasing the success of eradication campaigns and widespread screening.
Nevertheless, the research advises caution regarding the widespread elimination of H. pylori due to the risk of antibiotic resistance. It advocates for a measured evaluation of the pros and cons, as well as the cost-effectiveness of such interventions. The authors call for additional large-scale clinical trials to verify these results and improve public health tactics.
The findings indicate that precise public health actions can greatly influence disease prevention, underlining the necessity of well-informed policies backed by ongoing clinical research and trials. Such an informed approach is essential to confirm that the advantages of eradication surpass the potential dangers, particularly considering the growing concern over antibiotic resistance. This study lays the groundwork for effective gastric cancer prevention strategies and emphasizes the ongoing need for research to shape sound public health policies and actions.
Li-Ju Chen, PhD, is a postdoctoral researcher in the Division of Clinical Epidemiology and Aging Research at the German Cancer Research Center, Heidelberg, Germany. She declared no conflicts of interest in regard to this review.
Chen et al.’s study establishes a connection between the global decline in H. pylori infection rates and the decrease in gastric cancer cases, analyzing data from 1,748 articles across 111 countries. It highlights a significant drop in adult H. pylori prevalence from 52.6% before 1990 to 43.9% between 2015 and 2022, crediting improvements in socioeconomic conditions, water quality, and sanitation, along with targeted eradication efforts. This emphasizes the critical role of public health measures in reducing H. pylori infections and, consequently, gastric cancer risks, showcasing the success of eradication campaigns and widespread screening.
Nevertheless, the research advises caution regarding the widespread elimination of H. pylori due to the risk of antibiotic resistance. It advocates for a measured evaluation of the pros and cons, as well as the cost-effectiveness of such interventions. The authors call for additional large-scale clinical trials to verify these results and improve public health tactics.
The findings indicate that precise public health actions can greatly influence disease prevention, underlining the necessity of well-informed policies backed by ongoing clinical research and trials. Such an informed approach is essential to confirm that the advantages of eradication surpass the potential dangers, particularly considering the growing concern over antibiotic resistance. This study lays the groundwork for effective gastric cancer prevention strategies and emphasizes the ongoing need for research to shape sound public health policies and actions.
Li-Ju Chen, PhD, is a postdoctoral researcher in the Division of Clinical Epidemiology and Aging Research at the German Cancer Research Center, Heidelberg, Germany. She declared no conflicts of interest in regard to this review.
, according to investigators.
These findings suggest that decreasing H. pylori prevalence does indeed reduce rates of gastric cancer, although large-scale clinical trials are needed to solidify confidence in this apparent relationship, reported lead author Yi Chun Chen, PhD, of National Taiwan University, Taipei, and colleagues.
“Eradication of H. pylori infection heals chronic active gastritis and peptic ulcer disease and reduces the risk of peptic ulcer bleeding in aspirin users and the risk of gastric cancer in infected individuals,” the investigators wrote in Gastroenterology. “However, whether reduction of the prevalence of H. pylori is associated with a reduction of the incidence of gastric cancer at the population level remains uncertain.”
According to several previous meta-analyses, the global rate of H. pylori infection has been in a downtrend, but Dr. Chen and colleagues pointed out several limitations of these publications, including scarcity of recent data, insufficiently representative data, inconsistent diagnostic methods, and lack of adjustment for socioeconomic status.
“We therefore conducted this comprehensive systematic review and meta-analysis, including healthy individuals recruited in hospital-based studies, to provide an updated global prevalence and the secular trend of H. pylori infection,” the investigators wrote, noting that they leveraged meta-regression analysis to “identify factors affecting heterogeneity of the prevalence,” and concurrently evaluated the corresponding global incidence of gastric cancer.
Their dataset, which included 1,748 articles from 111 countries, suggested that the global rate of H. pylori is indeed in a downtrend.
From a crude global prevalence of 52.6% prior to 1990, the rate of H. pylori decreased to 43.9% among adults in 2015-2022, but was “still as high as” 35.1% among children and adolescents in the same 2015-2022 period. Multivariate regression analysis showed that prevalence decreased significantly, by 15.9%, among adults, but not in children and adolescents.
“The significant reduction of H. pylori prevalence in adults can be explained by the improvement of socioeconomic status, cleaner water supply, better sanitation and hygiene status, and widening of indication for eradication therapy,” Dr. Chen and colleagues wrote. “The higher prevalence in adults than in children/adolescents is explained by the cohort effect because most H. pylori infection is acquired in childhood.”
Global incidence of gastric cancer among both male and female individuals declined approximately in parallel with decreasing prevalence of H. pylori. Rates of gastric cancer decreased most in high-incidence countries such as Brazil, Japan, and China.
“These studies collectively provide evidence for the causal association of H. pylori infection and gastric cancer and that elimination of this bacterium can prevent the development of gastric cancer,” the investigators wrote.
Still, more work is needed.
“Future prospective studies should be conducted to confirm whether public health interventions or mass screening and eradication of H. pylori infection to reduce its prevalence may reduce the incidence of gastric cancer at population level,” Dr. Chen and colleagues concluded. “Besides, it is also important to consider the potential adverse consequences of H. pylori eradication, such as emergence of antibiotic resistance. The benefit-to-harm ratio and cost-effectiveness should also be taken into account.”
The study was funded by the National Taiwan University Hospital, the Taiwan Ministry of Science and Technology, the Taiwan Ministry of Health and Welfare, and others. The investigators disclosed no conflicts of interest.
, according to investigators.
These findings suggest that decreasing H. pylori prevalence does indeed reduce rates of gastric cancer, although large-scale clinical trials are needed to solidify confidence in this apparent relationship, reported lead author Yi Chun Chen, PhD, of National Taiwan University, Taipei, and colleagues.
“Eradication of H. pylori infection heals chronic active gastritis and peptic ulcer disease and reduces the risk of peptic ulcer bleeding in aspirin users and the risk of gastric cancer in infected individuals,” the investigators wrote in Gastroenterology. “However, whether reduction of the prevalence of H. pylori is associated with a reduction of the incidence of gastric cancer at the population level remains uncertain.”
According to several previous meta-analyses, the global rate of H. pylori infection has been in a downtrend, but Dr. Chen and colleagues pointed out several limitations of these publications, including scarcity of recent data, insufficiently representative data, inconsistent diagnostic methods, and lack of adjustment for socioeconomic status.
“We therefore conducted this comprehensive systematic review and meta-analysis, including healthy individuals recruited in hospital-based studies, to provide an updated global prevalence and the secular trend of H. pylori infection,” the investigators wrote, noting that they leveraged meta-regression analysis to “identify factors affecting heterogeneity of the prevalence,” and concurrently evaluated the corresponding global incidence of gastric cancer.
Their dataset, which included 1,748 articles from 111 countries, suggested that the global rate of H. pylori is indeed in a downtrend.
From a crude global prevalence of 52.6% prior to 1990, the rate of H. pylori decreased to 43.9% among adults in 2015-2022, but was “still as high as” 35.1% among children and adolescents in the same 2015-2022 period. Multivariate regression analysis showed that prevalence decreased significantly, by 15.9%, among adults, but not in children and adolescents.
“The significant reduction of H. pylori prevalence in adults can be explained by the improvement of socioeconomic status, cleaner water supply, better sanitation and hygiene status, and widening of indication for eradication therapy,” Dr. Chen and colleagues wrote. “The higher prevalence in adults than in children/adolescents is explained by the cohort effect because most H. pylori infection is acquired in childhood.”
Global incidence of gastric cancer among both male and female individuals declined approximately in parallel with decreasing prevalence of H. pylori. Rates of gastric cancer decreased most in high-incidence countries such as Brazil, Japan, and China.
“These studies collectively provide evidence for the causal association of H. pylori infection and gastric cancer and that elimination of this bacterium can prevent the development of gastric cancer,” the investigators wrote.
Still, more work is needed.
“Future prospective studies should be conducted to confirm whether public health interventions or mass screening and eradication of H. pylori infection to reduce its prevalence may reduce the incidence of gastric cancer at population level,” Dr. Chen and colleagues concluded. “Besides, it is also important to consider the potential adverse consequences of H. pylori eradication, such as emergence of antibiotic resistance. The benefit-to-harm ratio and cost-effectiveness should also be taken into account.”
The study was funded by the National Taiwan University Hospital, the Taiwan Ministry of Science and Technology, the Taiwan Ministry of Health and Welfare, and others. The investigators disclosed no conflicts of interest.
FROM GASTROENTEROLOGY