Gastric cancer prevention by H. pylori eradication in China: a meta-analysis of 8 high-quality RCTs in targeted screening populations
Abstract
Objective: Currently, existing studies lack specific long-term follow-up subgroup analyses for the Chinese population and fail to clarify how sample size and recruitment strategies affect the heterogeneous efficacy of Hp eradication. We therefore integrated data from Hp eradication therapy studies in Chinese Hp-positive patients with ≥3 years of follow-up, quantitatively analyzed the therapy's impact on gastric cancer risk, and explored preventive effect differences across subgroups with varying sample sizes. This study aims to provide evidence-based support for clinical decision-making in gastric cancer primary prevention and the formulation of public health strategies.
Methods: We searched six major databases: PubMed, Embase, the Cochrane Library, Web of Science, Wanfang Database, and CNKI (China National Knowledge Infrastructure). The search included all relevant randomized controlled trials (RCTs) from each database's inception to December 31, 2025. After screening based on inclusion and exclusion criteria, we used RevMan 5.3 software for risk of bias assessment, effect size pooling, and subgroup analysis. We assessed evidence quality using the GRADE approach.
Results: A total of 8 high-quality randomized controlled trials (RCTs) were included, with 260,609 participants (118,425 receiving Helicobacter pylori [Hp] eradication therapy). Pooled analysis showed that Hp eradication therapy significantly reduced gastric cancer risk by 18% (RR = 0.82, 95%CI: 0.73-0.91, P =…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 260,609 participants or records.
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