BackgroundHelicobacter pylori (H. pylori) is closely related to the carcinogenesis of gastric cancer (GC) and gastric non-Hodgkin lymphoma (NHL). However, the systemic trend analysis in H. pylori-related malignancy is limited. We aimed to determine the national incidence trend in non-cardia GC, cardia GC, and gastric NHL in the US during 2000–2019.MethodIn this population-based study, we included 186,769 patients with a newly diagnosed H. pylori-related malignancy, including non-cardia GC, cardia GC, and gastric NHL from the Surveillance, Epidemiology, and End Results (SEER) Registry from January 1, 2000 to December 31, 2019. We determined the age-adjusted incidence of three H. pylori-related malignancies respectively. Average annual percentage change (AAPC) in 2000–2019 was calculated to describe the incidence trends. Analyses were stratified by sex, age, race and ethnicity, geographic location and SEER registries. We also determined the 5-year incidence (during 2015–2019) by SEER registries to examine the geographic variance.ResultsThe incidence in non-cardia GC and gastric NHL significantly decreased during 2000–2019, while the rate plateaued for cardia GC (AAPCs, −1.0% [95% CI, −1.1%−0.9%], −2.6% [95% CI, −2.9%−2.3%], and −0.2% [95% CI, −0.7%−0.3%], respectively). For non-cardia GC, the incidence significantly increased among individuals aged 20–64 years (AAPC, 0.8% [95% CI, 0.6–1.0%]). A relative slower decline in incidence was also observed for women (AAPC, −0.4% [95% CI, −0.6%−0.2%], P for interaction < 0.05). The incidence of cardia GC reduced dramatically among Hispanics (AAPC, −0.8% [95% CI, −1.4%−0.3%]), however it increased significantly among nonmetropolitan residents (AAPC, 0.8% [95% CI, 0.4–1.3%]). For gastric NHL, the decreasing incidence were significantly slower for those aged 20–64 years (AAPC, −1.5% [95% CI, −1.9–1.1%]) and Black individuals (AAPC, −1.3% [95% CI, −1.9–1.1%]). Additionally, the highest incidence was observed among Asian and the Black for non-cardia GC, while Whites had the highest incidence of cardia GC and Hispanics had the highest incidence of gastric NHL (incidence rate, 8.0, 8.0, 3.1, and 1.2, respectively) in 2019. Geographic variance in incidence rates and trends were observed for all three H. pylori-related malignancies. The geographic disparities were more pronounced for non-cardia GC, with the most rapid decline occurring in Hawaii (AAPC, −4.5% [95% CI, −5.5–3.6%]) and a constant trend in New York (AAPC 0.0% [95% CI, −0.4–0.4%]), the highest incidence in Alaska Natives, and the lowest incidence among Iowans (14.3 and 2.3, respectively).ConclusionThe incidence of H. pylori-related cancer declined dramatically in the US between 2000 and 2019, with the exception of cardia GC. For young people, a rising trend in non-cardia GC was noted. Existence of racial/ethnic difference and geographic diversity persists. More cost-effective strategies of detection and management for H. pylori are still in demand.

Background: Breast cancer (BC) is a malignant tumor with the highest incidence rate worldwide, and its incidence of breast cancer brain metastases is increased in recent years. Although significant progress has been made in the systematic treatment of BC that of breast cancer brain metastases is still very difficult. Organically integrating local and systemic therapies remains an urgent problem to be solved. In this study, a network meta-analysis was performed to collect the treatment effects of different treatment measures on patients with BC brain metastasis in recent years, evaluate and screen the current best clinical treatment scheme, and assist doctors in formulating clinical treatment schemes.Methods: Keywords were used to search databases, such as the Chinese Journal Full-text Database, VIP Chinese Science and Technology Journal Full-text Database (VP-CSJFD), Wanfang Data Journal Paper Resources (Wangfang), PubMed, the Cochrane Library, and EMBASE. The retrieval period was from the establishment of each database to February 2022. Qualified randomized controlled studies were screened according to the inclusion and exclusion criteria, and Stata 16 software was adopted for mesh meta-analysis of binary variable data. Using R4 0.2 software, and calling GeMTC and JAGS packages in R software, the Bayesian network model analysis of survival data was completed. Conclusion:Combined with overall response rate, disease control rate, and overall survival, whole-brain radiation therapy + 3-dimensional conformal radiation therapy + Che may be the intervention measure with the highest objective remission rate for patients with brain metastasis of BC, besides, it may also be the intervention measure of the highest disease control rate in patients after treatment. In contrast, WBRT + Che may be the intervention with the lowest overall survival risk ratio after treatment.