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The epidemiology of Helicobacter pylori infection in Europe and the impact of lifestyle on its natural evolution toward stomach cancer after infection: A systematic review
Author(s) -
Venneman Kimberly,
Huybrechts Inge,
Gunter Marc J.,
Vandendaele Lieve,
Herrero Rolando,
Van Herck Koen
Publication year - 2018
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12483
Subject(s) - helicobacter pylori , cancer , stomach , stomach cancer , epidemiology , medicine , disease , environmental health
Abstract Background Helicobacter pylori is a recognized cause of stomach cancer, but only a fraction of infected subjects develop cancer. This systematic review 1, summarizes the prevalence of infection with this bacterium in Europe; and 2, reviews the possible impact of particular lifestyles in progression from infection to stomach cancer. Materials and Methods A systematic literature search was conducted in two databases by two independent investigators. Studies describing prevalence of infection among European healthy adult populations and worldwide studies analyzing the impact of lifestyle factors in association with H. pylori on stomach cancer risk were included. Results Variable H. pylori infection prevalence was observed depending on region and study period. The lowest infection prevalences were found in Northern Europe, while the highest were in Eastern and Southern Europe, up to 84% in Portugal and Poland. Studies on smoking, salt, and meat consumption demonstrated increased risks of developing stomach cancer among H. pylori ‐infected individuals, while studies relating the intake of fruit, vegetables, and vitamins demonstrated decreased risks, but the levels of significance differed importantly between studies. No significant interaction could be found for alcohol consumption or physical activity. Conclusions Recent data showed remaining high H. pylori infection rates in several European regions. This systematic review suggests that a number of correctable lifestyle factors could impact the disease progression toward H. pylori ‐associated stomach cancer. However, additional research is required to determine the potential role of targeted interventions in reducing stomach cancer development after H. pylori infection.