THE EFFECTS OF HELICOBACTER PYLORI ERADICATION THERAPY ON THE INCIDENCE OF GASTRIC ADENOCARCINOMA

Abstract

INTRODUCTION: Helicobacter pylori is the major risk factor for the development of gastric adenocarcinoma, and may increase its risk by two times. Thus, in the last twenty years, many studies have investigated whether eradicating this agent reduces the risk of gastric cancer. However, the results were initially inconsistent. Therefore, this systematic review was carried out to identify the impact of H. pylori eradication  on the incidence of gastric adenocarcinoma. METHOD: Using the Pubmed, Cochrane, Medline, and LILACS databases, a systematic review of studies involving H. pylori eradication treatment  and the incidence of gastric adenocarcinoma was carried out from 2019 to 2024. Meta-analyses, reviews, systematic reviews, clinical trials, and randomized controlled trials in English, involving humans, were included in the review. RESULTS: 12 studies were included. All of them showed that the eradication of H. pylori reduced the incidence of gastric adenocarcinoma in individuals without preneoplastic lesions, so that this decrease ranged from 43% to 76% among the articles (CI=95%). DISCUSSION: Gastric adenocarcinoma is unlikely to develop in those not infected with H. pylori. Thus, investigating the effects of the eradication of this bacterium is of great interest to public health. Many factors interfere with the relationship between H. pylori and host and, therefore, with the development of gastric cancer. To mention, the socioeconomic condition and specific virulence factors. Another challenge in the issue of H. pylori is the treatment of the infection, due to the variety of strains and antimicrobial resistance, making it difficult to eradicate. In countries where H. pylori infection  and gastric cancer are very prevalent, strategies aimed at analyzing the susceptibility of certain strains to antimicrobials and identifying which genes are responsible for this resistance may be the key to controlling the infection and, therefore, to reducing gastric cancer cases. CONCLUSION: Eradication of H. pylori decreases the incidence of gastric adenocarcinoma. Thus, screening and treating these infections in populations with a high prevalence of H. pylori is beneficial to prevent gastric cancer, with public health in mind.

DOI:https://doi.org/10.56238/sevened2024.029-057