The global prevalence of gastric cancer in Helicobacter pylori-infected individuals: a systematic review and meta-analysis

Maryam Shirani; Reza Pakzad; Mohammad Hossein Haddadi; Sousan Akrami; Arezoo Asadi; Hossein Kazemian; Melika Moradi; Vahab Hassan Kaviar; Abolfazl Rafati Zomorodi; Saeed Khoshnood; Mahnaz Shafieian; Ronia Tavasolian; Mohsen Heidary; Morteza Saki

doi:10.1186/s12879-023-08504-5

The global prevalence of gastric cancer in Helicobacter pylori-infected individuals: a systematic review and meta-analysis

BMC Infect Dis. 2023 Aug 19;23(1):543. doi: 10.1186/s12879-023-08504-5.

Authors

Maryam Shirani^#¹, Reza Pakzad^#^{2

3}, Mohammad Hossein Haddadi⁴, Sousan Akrami^{5

6}, Arezoo Asadi⁷, Hossein Kazemian⁴, Melika Moradi⁶, Vahab Hassan Kaviar⁸, Abolfazl Rafati Zomorodi⁹, Saeed Khoshnood^{3

4}, Mahnaz Shafieian¹⁰, Ronia Tavasolian¹¹, Mohsen Heidary^{12

13}, Morteza Saki¹⁴

Affiliations

¹ Toxicology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
² Department of Epidemiology, Faculty of Health, Ilam University Medical Sciences, Ilam, Iran.
³ Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran.
⁴ Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran.
⁵ Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
⁶ Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
⁷ Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
⁸ Department of Medical Microbiology, Faculty of Medicine, Ilam University of Medical Science, Ilam, Iran.
⁹ Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
¹⁰ Department of Midwifery, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran.
¹¹ Department of Medicine, Faculty of Nutrition Science, University of Cheste, Chester, UK.
¹² Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran. mohsenheidary40@gmail.com.
¹³ Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran. mohsenheidary40@gmail.com.
¹⁴ Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. mortezasaki1981@gmail.com.

^# Contributed equally.

Abstract

Background: Helicobacter pylori is a gastrointestinal pathogen that infects around half of the world's population. H. pylori infection is the most severe known risk factor for gastric cancer (GC), which is the second highest cause of cancer-related deaths globally. We conducted a systematic review and meta-analysis to assess the global prevalence of GC in H. pylori-infected individuals.

Methods: We performed a systematic search of the PubMed, Web of Science, and Embase databases for studies of the prevalence of GC in H. pylori-infected individuals published from 1 January 2011 to 20 April 2021. Metaprop package were used to calculate the pooled prevalence with 95% confidence interval. Random-effects model was applied to estimate the pooled prevalence. We also quantified it with the I² index. Based on the Higgins classification approach, I² values above 0.7 were determined as high heterogeneity.

Results: Among 17,438 reports screened, we assessed 1053 full-text articles for eligibility; 149 were included in the final analysis, comprising data from 32 countries. The highest and lowest prevalence was observed in America (pooled prevalence: 18.06%; 95% CI: 16.48 - 19.63; I²: 98.84%) and Africa (pooled prevalence: 9.52%; 95% CI: 5.92 - 13.12; I²: 88.39%). Among individual countries, Japan had the highest pooled prevalence of GC in H. pylori positive patients (Prevalence: 90.90%:95% CI: 83.61-95.14), whereas Sweden had the lowest prevalence (Prevalence: 0.07%; 95% CI: 0.06-0.09). The highest and lowest prevalence was observed in prospective case series (pooled prevalence: 23.13%; 95% CI: 20.41 - 25.85; I2: 97.70%) and retrospective cohort (pooled prevalence: 1.17%; 95% CI: 0.55 - 1.78; I 2: 0.10%).

Conclusions: H. pylori infection in GC patients varied between regions in this systematic review and meta-analysis. We observed that large amounts of GCs in developed countries are associated with H. pylori. Using these data, regional initiatives can be taken to prevent and eradicate H. pylori worldwide, thus reducing its complications.

Keywords: Gastric cancer; Helicobacter pylori; Infection; Meta-analysis; Prevalence; Systematic review.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Africa
Helicobacter pylori*
Humans
Prevalence
Retrospective Studies
Stomach Neoplasms* / epidemiology