Helicobacter pylori eradication therapy to prevent gastric cancer: systematic review and meta-analysis.
Identifieur interne : 000339 ( Main/Exploration ); précédent : 000338; suivant : 000340Helicobacter pylori eradication therapy to prevent gastric cancer: systematic review and meta-analysis.
Auteurs : Alexander Charles Ford [Oman, Royaume-Uni] ; Yuhong Yuan [Canada] ; Paul Moayyedi [Canada]Source :
- Gut [ 1468-3288 ] ; 2020.
Abstract
OBJECTIVES
Gastric cancer is strongly associated with
DESIGN
We searched the medical literature through February 2020 to identify randomised controlled trials (RCTs) examining effect of eradication therapy on subsequent occurrence of gastric cancer in healthy
RESULTS
We identified 10 RCTs, seven recruited 8323 healthy individuals, and three randomised 1841 patients with gastric neoplasia. In healthy individuals, eradication therapy reduced incidence of gastric cancer (RR=0.54; 95% CI 0.40 to 0.72, NNT=72), and reduced mortality from gastric cancer (RR=0.61; 95% CI 0.40 to 0.92, NNT=135), but did not affect all-cause mortality. These data suggest that 8 743 815 DALYs (95% CI 5 646 173 to 11 847 456) would be gained if population screening and treatment was implemented globally. In patients with gastric neoplasia, eradication therapy also reduced incidence of future gastric cancer (RR=0.49; 95% CI 0.34 to 0.70, NNT=21). Adverse events were incompletely reported.
CONCLUSION
There is moderate evidence to suggest that
DOI: 10.1136/gutjnl-2020-320839
PubMed: 32205420
Affiliations:
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James's, University of Leeds, Leeds</wicri:regionArea><orgName type="university">Université de Leeds</orgName><placeName><settlement type="city">Leeds</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Yorkshire-et-Humber</region></placeName></affiliation></author><author><name sortKey="Yuan, Yuhong" sort="Yuan, Yuhong" uniqKey="Yuan Y" first="Yuhong" last="Yuan">Yuhong Yuan</name><affiliation wicri:level="1"><nlm:affiliation>Division of Gastroenterology, McMaster University Medical Center, Hamilton, Ontario, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Gastroenterology, McMaster University Medical Center, Hamilton, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Moayyedi, Paul" sort="Moayyedi, Paul" uniqKey="Moayyedi P" first="Paul" last="Moayyedi">Paul Moayyedi</name><affiliation wicri:level="1"><nlm:affiliation>Division of Gastroenterology, McMaster University Medical Center, Hamilton, Ontario, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Gastroenterology, McMaster University Medical Center, Hamilton, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32205420</idno><idno type="pmid">32205420</idno><idno type="doi">10.1136/gutjnl-2020-320839</idno><idno type="wicri:Area/Main/Corpus">000225</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000225</idno><idno type="wicri:Area/Main/Curation">000225</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000225</idno><idno type="wicri:Area/Main/Exploration">000225</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en"><i>Helicobacter pylori</i> eradication therapy to prevent gastric cancer: systematic review and meta-analysis.</title><author><name sortKey="Ford, Alexander Charles" sort="Ford, Alexander Charles" uniqKey="Ford A" first="Alexander Charles" last="Ford">Alexander Charles Ford</name><affiliation wicri:level="1"><nlm:affiliation>Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, West Yorkshire, UK alexf12399@yahoo.com.</nlm:affiliation><country wicri:rule="url">Oman</country><wicri:regionArea>Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, West Yorkshire</wicri:regionArea><wicri:noRegion>West Yorkshire</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Leeds Institute of Medical Research at St James's, University of Leeds, Leeds</wicri:regionArea><orgName type="university">Université de Leeds</orgName><placeName><settlement type="city">Leeds</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Yorkshire-et-Humber</region></placeName></affiliation></author><author><name sortKey="Yuan, Yuhong" sort="Yuan, Yuhong" uniqKey="Yuan Y" first="Yuhong" last="Yuan">Yuhong Yuan</name><affiliation wicri:level="1"><nlm:affiliation>Division of Gastroenterology, McMaster University Medical Center, Hamilton, Ontario, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Gastroenterology, McMaster University Medical Center, Hamilton, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Moayyedi, Paul" sort="Moayyedi, Paul" uniqKey="Moayyedi P" first="Paul" last="Moayyedi">Paul Moayyedi</name><affiliation wicri:level="1"><nlm:affiliation>Division of Gastroenterology, McMaster University Medical Center, Hamilton, Ontario, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Gastroenterology, McMaster University Medical Center, Hamilton, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author></analytic><series><title level="j">Gut</title><idno type="eISSN">1468-3288</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>Gastric cancer is strongly associated with </p></div><div type="abstract" xml:lang="en"><p><b>DESIGN</b></p><p>We searched the medical literature through February 2020 to identify randomised controlled trials (RCTs) examining effect of eradication therapy on subsequent occurrence of gastric cancer in healthy </p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>We identified 10 RCTs, seven recruited 8323 healthy individuals, and three randomised 1841 patients with gastric neoplasia. In healthy individuals, eradication therapy reduced incidence of gastric cancer (RR=0.54; 95% CI 0.40 to 0.72, NNT=72), and reduced mortality from gastric cancer (RR=0.61; 95% CI 0.40 to 0.92, NNT=135), but did not affect all-cause mortality. These data suggest that 8 743 815 DALYs (95% CI 5 646 173 to 11 847 456) would be gained if population screening and treatment was implemented globally. In patients with gastric neoplasia, eradication therapy also reduced incidence of future gastric cancer (RR=0.49; 95% CI 0.34 to 0.70, NNT=21). Adverse events were incompletely reported.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>There is moderate evidence to suggest that </p></div></front></TEI><pubmed><MedlineCitation Status="In-Data-Review" Owner="NLM"><PMID Version="1">32205420</PMID><DateRevised><Year>2020</Year><Month>11</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1468-3288</ISSN><JournalIssue CitedMedium="Internet"><Volume>69</Volume><Issue>12</Issue><PubDate><Year>2020</Year><Month>Dec</Month></PubDate></JournalIssue><Title>Gut</Title><ISOAbbreviation>Gut</ISOAbbreviation></Journal><ArticleTitle><i>Helicobacter pylori</i> eradication therapy to prevent gastric cancer: systematic review and meta-analysis.</ArticleTitle><Pagination><MedlinePgn>2113-2121</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/gutjnl-2020-320839</ELocationID><Abstract><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">Gastric cancer is strongly associated with <i>Helicobacter pylori</i> (<i>H. pylori</i>). We conducted a previous systematic review and meta-analysis that suggested eradication therapy reduced future incidence of gastric cancer, but effect size was uncertain, and there was no reduction in gastric cancer-related mortality. We updated this meta-analysis, as more data has accumulated. We also evaluated impact of eradication therapy on future risk of gastric cancer in patients having endoscopic mucosal resection for gastric neoplasia.</AbstractText><AbstractText Label="DESIGN" NlmCategory="METHODS">We searched the medical literature through February 2020 to identify randomised controlled trials (RCTs) examining effect of eradication therapy on subsequent occurrence of gastric cancer in healthy <i>H. pylori</i>-positive adults, and in <i>H. pylori</i>-positive patients with gastric neoplasia undergoing endoscopic mucosal resection. The control arm received placebo or no treatment. Follow-up was for ≥2 years. We estimated the relative risk (RR) number needed to treat (NNT), and evaluated the disability-adjusted life-years (DALYs) gained from screening from the meta-analysis.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">We identified 10 RCTs, seven recruited 8323 healthy individuals, and three randomised 1841 patients with gastric neoplasia. In healthy individuals, eradication therapy reduced incidence of gastric cancer (RR=0.54; 95% CI 0.40 to 0.72, NNT=72), and reduced mortality from gastric cancer (RR=0.61; 95% CI 0.40 to 0.92, NNT=135), but did not affect all-cause mortality. These data suggest that 8 743 815 DALYs (95% CI 5 646 173 to 11 847 456) would be gained if population screening and treatment was implemented globally. In patients with gastric neoplasia, eradication therapy also reduced incidence of future gastric cancer (RR=0.49; 95% CI 0.34 to 0.70, NNT=21). Adverse events were incompletely reported.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">There is moderate evidence to suggest that <i>H. pylori</i> eradication therapy reduces the incidence of gastric cancer in healthy individuals and patients with gastric neoplasia in East Asian countries. There also appears to be a reduction in gastric cancer-related mortality.</AbstractText><CopyrightInformation>© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ford</LastName><ForeName>Alexander Charles</ForeName><Initials>AC</Initials><Identifier Source="ORCID">http://orcid.org/0000-0001-6371-4359</Identifier><AffiliationInfo><Affiliation>Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, West Yorkshire, UK alexf12399@yahoo.com.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yuan</LastName><ForeName>Yuhong</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Division of Gastroenterology, McMaster University Medical Center, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Moayyedi</LastName><ForeName>Paul</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Division of Gastroenterology, McMaster University Medical Center, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>03</Month><Day>23</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Gut</MedlineTA><NlmUniqueID>2985108R</NlmUniqueID><ISSNLinking>0017-5749</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">gastric cancer</Keyword><Keyword MajorTopicYN="N">helicobacter pylori</Keyword><Keyword MajorTopicYN="N">meta-analysis</Keyword></KeywordList><CoiStatement>Competing interests: PM: has received honoraria from Allergan and Salix, and research funding from Allergan.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>02</Month><Day>06</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>02</Month><Day>26</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>03</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>3</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>3</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>3</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32205420</ArticleId><ArticleId IdType="pii">gutjnl-2020-320839</ArticleId><ArticleId IdType="doi">10.1136/gutjnl-2020-320839</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Canada</li><li>Oman</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Yorkshire-et-Humber</li></region><settlement><li>Leeds</li></settlement><orgName><li>Université de Leeds</li></orgName></list><tree><country name="Oman"><noRegion><name sortKey="Ford, Alexander Charles" sort="Ford, Alexander Charles" uniqKey="Ford A" first="Alexander Charles" last="Ford">Alexander Charles Ford</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Ford, Alexander Charles" sort="Ford, Alexander Charles" uniqKey="Ford A" first="Alexander Charles" last="Ford">Alexander Charles Ford</name></region></country><country name="Canada"><noRegion><name sortKey="Yuan, Yuhong" sort="Yuan, Yuhong" uniqKey="Yuan Y" first="Yuhong" last="Yuan">Yuhong Yuan</name></noRegion><name sortKey="Moayyedi, Paul" sort="Moayyedi, Paul" uniqKey="Moayyedi P" first="Paul" last="Moayyedi">Paul Moayyedi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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