Alimentary TractMeta-analysis of the relationship between Helicobacter pylori seropositivity and gastric cancer☆
Section snippets
Justification of the systematic review
A MEDLINE search of the English language literature for human studies was performed using textword “Campylobacter pylori” and MeSH term “stomach neoplasms” from 1983 to 1990 and using MeSH terms “Helicobacter pylori, stomach neoplasms” from 1990 to April 1996. A total of 47 relevant reviews was identified. With criteria described by Cook et al.29 and by Greenland30 and with guidelines for the application of meta-analysis in epidemiological studies,31 these were evaluated critically by one of
Peer-reviewed publications
MEDLINE search generated a total of 58 peer-reviewed primary studies for retrieval. However, only 32 studies reported serological testing for H. pylori infection. Manual search identified another three references for a total of 35 potentially relevant articles. Sixteen studies were excluded for various reasons: no matched control group,17, 47, 48, 49, 50, 51, 52 no serological data53 or raw data,54 and same data source.55, 56, 57, 58, 59, 60, 61 Nineteen studies met the predetermined inclusion
Discussion
Since Warren and Marshall first isolated H. pylori from the stomachs of patients with gastritis,62 numerous epidemiological studies and reviews have been published regarding the relationship between H. pylori infection and the development of gastric cancer.13 However, none of the previous reviews has evaluated the literature systematically and statistically with the exception of 1 article by Forman et al.14 To our knowledge, this is the first comprehensive meta-analysis addressing the
Acknowledgements
The authors thank the following original investigators for their generosity in providing primary data on the age distributions of subjects in their studies (names in alphabetical order): Drs. A. Archimandritis, M. Asaka, P. Fidalgo, D. Forman, H. Fukuda, E. J. Kuipers, A. Nomura, J. Parsonnet, J. Rudi, P. Sipponen, N. J. Talley, and P. M. Webb; Dr. J. T. Lin for providing information on their studies; S. Walter and A. Willan for their helpful suggestions on the statistical analysis; and David
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Address requests for reprints to: Richard H. Hunt, M.D., Division of Gastroenterology, Department of Medicine, McMaster University Medical Centre, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5. e-mail: [email protected]; fax: (905) 521-5072.