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Helicobacter pylori infection reduces the risk of Barrett's esophagus: A meta‐analysis and systematic review
Author(s) -
Erőss Bálint,
Farkas Nelli,
Vincze Áron,
Tinusz Benedek,
Szapáry László,
Garami András,
Balaskó Márta,
Sarlós Patrícia,
Czopf László,
Alizadeh Hussain,
Rakonczay Zoltán,
Habon Tamás,
Hegyi Péter
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.12504
Subject(s) - medicine , meta analysis , odds ratio , dysplasia , barrett's esophagus , context (archaeology) , subgroup analysis , gastroenterology , helicobacter pylori , esophagus , esophageal adenocarcinoma , relative risk , adenocarcinoma , cancer , confidence interval , biology , paleontology
The prevalence of Helicobacter pylori infection ( HPI ) has been decreasing in developed countries, with an increasing prevalence of Barrett's esophagus ( BE ) and esophageal adenocarcinoma ( EAC ) at the same time. The aim of our meta‐analysis was to quantify the risk of BE in the context of HPI . Methods A systematic search was conducted in 3 databases for studies on BE with data on prevalence of HPI from inception until December 2016. Odds ratios for BE in HPI were calculated by the random effects model with subgroup analyses for geographical location, presence of dysplasia in BE , and length of the BE segment. Results Seventy‐two studies were included in the meta‐analysis, including 84 717 BE cases and 390 749 controls. The overall analysis showed that HPI reduces the risk of BE ; OR = 0.68 (95% CI : 0.58‐0.79, P < .001). Subgroup analyses revealed risk reduction in Asia OR = 0.53 (95% CI : 0.33‐0.84, P = .007), Australia OR = 0.56 (95% CI : 0.39‐0.80, P = .002), Europe OR = 0.77 (95% CI : 0.60‐0.98, P = .035), and North‐America OR = 0.59 (95% CI : 0.47‐0.74, P < .001). The risk was significantly reduced for dysplastic BE , OR = 0.37 (95% CI : 0.26‐0.51, P < .001) for non‐dysplastic BE , OR = 0.51 (95% CI : 0.35‐0.75, P = .001), and for long segment BE , OR = 0.25 (95% CI : 0.11‐0.59, P = .001) in case of HPI . Conclusions This extensive meta‐analysis provides additional evidence that HPI is associated with reduced risk of BE . Subgroup analyses confirmed that this risk reduction is independent of geographical location. HPI is associated with significantly lower risk of dysplastic, non‐dysplastic, and long segment BE .