Clinical prevention of gastric cancer by Helicobacter pylori eradication therapy: a systematic review

Abstract

Helicobacter pylori (H. pylori) infection plays an important role in gastric carcinogenesis. We conducted a systematic review concerning gastric cancer development after H. pylori eradication therapy. In total 15 papers matched our criteria, the results were reviewed. The H. pylori eradication therapy statistically diminished the prevalence of clinical gastric cancer by approximately one-third. The studies from Japan supported this conclusion; however, studies from overseas reported conflicting results. The differences in these conclusions lie in the diagnostic ability of endoscopic examination, since the clinical stage was quite different between these studies. Gastric cancer that developed after eradication revealed a mainly intestinal type histology and depressed-type appearance. The following are possible reasons for reduced gastric cancer: (1) eradication therapy inhibits the new occurrence of gastric cancer, (2) eradication regresses or inhibits the growth of gastric cancer, and (3) eradication interferes with the discovery of gastric cancer. Considering the biological nature of cancer cell proliferation, a sufficiently long-term follow-up may clarify the effect of eradication therapy on inhibition of the development (not discovery) of gastric cancer and reduction of gastric cancer-related mortality.

Gastric Cancers Emerging after H. pylori Eradication Arise Exclusively from Non-Acid-Secreting Areas

“…Another limitation is that all cancer lesions in the present analysis were the intestinal type. Although the present results on the cancer histology are in agreement with a recent review describing that most gastric cancers that developed after eradication were the intestinaltype (Ito et al 2009), further studies on the diffuse-type of gastric cancer after H. pylori eradication are required.…”

Molecular Epidemiology of Helicobacter pylori in Brazilian Patients with Early Gastric Cancer and a Review to Understand the Prognosis of the Disease

“…As well as other authors mentioned before, Ito (2009) [132] considered that theoretically H. pylori eradication therapy should be beneficial for cancer prevention. However, attention should be drawn to the fact that the gastric cancer risk is not similar between noninfected and eradicated people.…”

Antibiotic Resistance of <i>Helicobacter pylori</i> and Eradication Rate in Japanese Pediatric Patients

“…Significant differences between year groups were determined by chi-square analysis (*P < 0.05, **P < 0.01). [19]- [28], and reduces the incidence of gastric cancer [5]- [10]. On the other hand, eradication therapy does not prevent the development of metachronous gastric cancer completely [29].…”

“…In 1994, H. pylori was declared a class I definite human carcinogen by the WHO [3] and this classification was confirmed in 2012 [4]. Eradication therapy against H. pylori infection can lead to significant improvement of gastric atrophy and may prevent the development of gastric cancer [5]- [10].…”