Association between the Helicobacter pylori Infection and the Risk of Pancreatic Cancer

Abstract

Background: Helicobacter pylori (H. pylori) bacteria has long been scrutinized as one of the potential risk factors for developing pancreatic cancer with inconsistent and unequivocal data. Globally, there is an increasing trend in pancreatic cancer incidence and mortality rates. Little is known about the risk factors involved with this malignancy. In this systematic review, we aimed to examine the relationship between H. pylori infection and pancreatic cancer based on the evidence from the existing observational studies worldwide. Methods: We searched major electronic databases such as PubMed, MEDLINE, Science Direct, and Cochrane library using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines. After a careful and thorough screening process, we selected 15 observation studies for this systematic review. Results: Six of 15 studies found a significant association between H. pylori infection and pancreatic cancer. Additionally, four of these studies found a significant relationship between the Cytotoxin-associated gene-A (CagA) strain of H. pylori and pancreatic cancer. Conclusion: Based on the evidence from the selected studies, a weak association was observed between H. pylori infection and cancer of the pancreas, especially in European and Asian populations compared to the North American population. The cross-sectional evidence from the case-control studies only suggests the existence of association but does not provide substantial evidence of the causative relationship. Further, large-scale prospective cohort studies are warranted in the future to understand this contradictory relationship better.