Population attributable burden of Helicobacter pylori-related gastric cancer, coronary heart disease, and ischemic stroke in China

Abstract

Helicobacter pylori, a risk factor of cancer and chronic diseases, remains highly prevalent in China. This review aims to systematically evaluate the H. pylori-attributable burden for gastric cancer (GC), coronary heart disease (CHD), and ischemic stroke (IS) in the Chinese population. Helicobacter pylori prevalence was updated by pooling the results reported in studies across China. The population attributable fraction (PAF) was calculated based on the H. pylori prevalence 10 years ago and relative risks of specific disease by reviewing the prospective studies published from 2000 through 2015. In China, the nationwide average prevalence of H. pylori was estimated to be 42.06 % in the general population during 2009-2013. The fixed effects pooled relative risk (RR) of 1.89 [95 % confidence interval (CI): 1.57-2.26] was obtained for gastric cancer and H. pylori infection. Helicobacter pylori infection was responsible for around 37.38 % of noncardia GC, corresponding to about 105,536 cases in 2012. As for extra-gastric disorders, H. pylori infections had higher risk of CHD (RR = 1.55, 95 % CI: 1.37-1.76) and IS (RR = 1.54, 95 % CI: 1.42-1.66). About 23.15 % of CHD and 22.29 % of IS were attributable to H. pylori infection. The estimates of H. pylori-attributable burden reveal a great potential of reducing H. pylori-related chronic disease burden by H. pylori eradication. Large prospective studies are warranted to identify which H. pylori strains, which subtypes of the disease, and which subgroups of the population have the greatest risk of relevant diseases and the effect of H. pylori eradication on the prevention of H. pylori-related diseases.

Effectiveness and safety of furazolidone‐containing quadruple regimens in patients with Helicobacter pylori infection in real‐world practice

“…Therefore, the reasons for individual differences in the eradication rate and adverse reactions of furazolidone‐containing therapies for H pylori infection remain largely unknown. The ability to safely and effectively treat the infection may eventually become a critical preventive care issue in China . Real‐world study (RWS) is a complement to RCTs, bringing the conclusions of RCT research back to the true clinical situation.…”

“…The ability to safely and effectively treat the infection may eventually become a critical preventive care issue in China. 19 Real-world study (RWS) is a complement to RCTs, bringing the conclusions of RCT research back to the true clinical situation. We conducted this study to determine the effectiveness and safety of furazolidone-containing quadruple regimens from evidence based on a real-world practice.…”

Efficacy and Safety of the Triple Therapy Containing Ilaprazole, Levofloxacin, and Amoxicillin as First-Line Treatment in Helicobacter pylori Infections

“…H. pylori infection may increase the risk for ischemic stroke. In a recent meta-analysis, a relative risk of 2.42 was obtained for stroke and H. pylori infection [25]; therefore, H. pylori eradication may prevent stroke [26]. However, there is no report that H. pylori eradication rate is associated with CVA.…”

Hellenic consensus on Helicobacter pylori infection

“…Based on these data, H. pylori eradication therapy was proposed as a cardiovascular prevention strategy [88]. However, to date there is insufficient direct evidence from prospective studies and RCTs that H. pylori eradication can reduce the incidence of CVD [89]. Moreover, there are studies that have failed to confirm a positive association.…”