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

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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.

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Authors and Affiliations

  1. Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, 450001, China

    J. Jiang, Y. Chen, C. Song & K. Wang

  2. Henan Key Laboratory of Tumor Epidemiology, Zhengzhou, China

    J. Jiang, Y. Chen, C. Song, J. Zhang & K. Wang

  3. College of Basic Medicine, Zhengzhou University, Zhengzhou, China

    J. Shi

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Supplementary Table 1

The detailed information from the studies on the prevalence of H. pylori across China (DOC 169 kb)

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Jiang, J., Chen, Y., Shi, J. et al. Population attributable burden of Helicobacter pylori-related gastric cancer, coronary heart disease, and ischemic stroke in China. Eur J Clin Microbiol Infect Dis 36, 199–212 (2017). https://doi.org/10.1007/s10096-016-2810-x

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