Helicobacter pylori infection reduces the risk of Barrett's esophagus: A meta-analysis and systematic review

Bálint Erőss, Nelli Farkas, A. Vincze, Benedek Tinusz, L. Szapáry, András Garami, M. Balaskó, Patrícia Sarlós, L. Czopf, Hussain Alizadeh, Z. Rakonczay, Tamás Habon, Péter Hegyi

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

Introduction: 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.

Original languageEnglish
Article numbere12504
JournalHelicobacter
Volume23
Issue number4
DOIs
Publication statusPublished - Aug 1 2018

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Barrett Esophagus
Helicobacter Infections
Helicobacter pylori
Meta-Analysis
Risk Reduction Behavior
North America
Developed Countries
Adenocarcinoma

Keywords

  • Barrett's esophagus
  • esophageal adenocarcinoma
  • gastroesophageal reflux disease
  • Helicobacter pylori
  • meta-analysis
  • systematic review

ASJC Scopus subject areas

  • Gastroenterology
  • Infectious Diseases

Cite this

Helicobacter pylori infection reduces the risk of Barrett's esophagus : A meta-analysis and systematic review. / Erőss, Bálint; Farkas, Nelli; Vincze, A.; Tinusz, Benedek; Szapáry, L.; Garami, András; Balaskó, M.; Sarlós, Patrícia; Czopf, L.; Alizadeh, Hussain; Rakonczay, Z.; Habon, Tamás; Hegyi, Péter.

In: Helicobacter, Vol. 23, No. 4, e12504, 01.08.2018.

Research output: Contribution to journalReview article

Erőss, Bálint ; Farkas, Nelli ; Vincze, A. ; Tinusz, Benedek ; Szapáry, L. ; Garami, András ; Balaskó, M. ; Sarlós, Patrícia ; Czopf, L. ; Alizadeh, Hussain ; Rakonczay, Z. ; Habon, Tamás ; Hegyi, Péter. / Helicobacter pylori infection reduces the risk of Barrett's esophagus : A meta-analysis and systematic review. In: Helicobacter. 2018 ; Vol. 23, No. 4.
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T2 - A meta-analysis and systematic review

AU - Erőss, Bálint

AU - Farkas, Nelli

AU - Vincze, A.

AU - Tinusz, Benedek

AU - Szapáry, L.

AU - Garami, András

AU - Balaskó, M.

AU - Sarlós, Patrícia

AU - Czopf, L.

AU - Alizadeh, Hussain

AU - Rakonczay, Z.

AU - Habon, Tamás

AU - Hegyi, Péter

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Introduction: 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.

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