Meta-analysisindependent cross-checkabstract only checked I-GUT-03 standard review
H. pylori treatment and stomach cancer
Helicobacter pylori eradication therapy to prevent gastric cancer: systematic review and meta-analysis.
Overview
Ford AC et al.. Gut 2020 · PMID 32205420 · DOI 10.1136/gutjnl-2020-320839
Eradication nearly halved gastric cancer incidence in trials.
Does the study support the specific claim? No · Methodological quality: high
Plain-language summary
Study explained simply
- What did the researchers want to find out?
GC prevention.
- How was the study done?
MA of RCTs.
- How many people, animals or samples were studied?
10,164.
- What was actually found?
Fewer cancers.
- How large was the observed effect?
RR 0.54.
- What do the results mean in everyday life?
Treating infection prevents cancer.
- What are the study's limitations?
East Asian.
- What does it say about Elawady's specific claim?
Contradicts C-GUT-06.
- Do the results apply to Germany and Europe?
Moderate.
Scientific in-depth review
1. Full reference
- Authors
- Ford AC et al.
- Journal
- Gut
- Year
- 2020
- Identifier
- PMID 32205420 DOI 10.1136/gutjnl-2020-320839
- Verification
- verified – PubMed efetch 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Competing interests: PM: has received honoraria from Allergan and Salix, and research funding from Allergan.
2. Research question
Does H. pylori eradication prevent gastric cancer?
3. Study design and population
- Study design
- Meta-analysis – Systematic review and meta-analysis of RCTs
- Population
Healthy H. pylori-positive adults; patients after endoscopic resection
- Country
Mostly East Asia
- Period
to Feb 2020
- Sample size
10 RCTs (8,323 healthy; 1,841 neoplasia)
- Inclusion and exclusion criteria
RCTs ≥2 years follow-up
4. Methods and endpoints
- Exposure / intervention
Eradication therapy
- Comparator
Placebo/no treatment
- Endpoints
Gastric cancer incidence and mortality
- Statistical methods
Pooled RR; NNT
5. Actual results
- Results
Healthy: GC incidence RR 0.54 (0.40–0.72), NNT 72; GC mortality RR 0.61 (0.40–0.92), NNT 135; no effect on all-cause mortality. Neoplasia: RR 0.49 (0.34–0.70), NNT 21.
- Absolute risks
NNT 72 (incidence), 135 (GC mortality)
- Authors' conclusion
Moderate evidence that eradication reduces gastric cancer incidence in East Asian countries.
6. Strengths
- RCTs
7. Weaknesses
- Mostly East Asian
- COI of one author
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- low
9. Assessment of the statistical interpretation
10. Relevance to the specific claim
11. Independent contrary findings
12. Transferability to Germany and Europe
Moderate (lower gastric cancer incidence in Europe).
13. Overall methodological judgement
Supports eradication.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | high |
| Risk of bias | low |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- Redefining peptic ulcer as an H. pylori infection was a 'crime'; the real problem is low stomach acid, and acid blockers plus antibiotic 'triple therapy' are the wrong treatment. – Studies contradicting or limiting the claim