Incidence Of Gastric Cancer Research Articles

Helicobacter (H.) pylori is the major risk factor of gastric cancer (GC). We aimed to estimate the population attributable fraction (PAF) of GC and the number of new GC cases and deaths for GC attributable to H. pylori in different countries worldwide in 2022. The PAF was estimated using country-specific pooled prevalence of H. pylori in the period 2000-2010 obtained through a systematic review and meta-analysis and a risk ratio of 5.9 for the association between H. pylori and GC. The absolute number of new GC cases and deaths for GC attributable to H. pylori was calculated using PAF and GC incidence and mortality reported by GLOBOCAN 2022. The PAF of GC due to H. pylori was calculated for 27 countries. The average PAF was 69.7% ranging from 40.7% in Malaysia to 82.3% in South Africa. The PAF was > 70% in all countries in the analysis in Africa, East Mediterranean region and Latin America, apart from Mexico, and in some countries in Western Pacific region (China, Japan and Korea) and Europe (Poland, Spain and Albania). The largest number of GC cases and deaths for GC attributable to H. pylori was estimated in China (GC: 252,850, deaths:184,666) and Japan (GC: 92,166, deaths: 31,809). More than two-thirds of new GC cases in the countries in the analysis were attributable to H. pylori in 2022. Our estimates may contribute to better investigate cost-effectiveness of H. pylori screening strategies for GC prevention in different countries worldwide.

Gastric cancer (GC) is a major social issue that is particularly acute in East Asia, Eastern Europe, and South America. Russia, where morbidity and mortality rates are higher than the global averages, still has no national GC screening, early detection and prevention programs. The aim of this review is to analyze current literature data on the incidence, mortality, and screening methods of gastric cancer (GC) in different countries of the world and in Russia. The average age-standardized rate (ASR) of GC incidence worldwide is 9.2 per 100,000 population, ASR of mortality is 6.1 per 100,000, and five-year survival for 2000–2014 varies from 20% to 40%. In Russia, the incidence and mortality rates of GC are 13.7 per 100,000 and 9.2 per 100,000, respectively. Unfavorable epidemiological indicators of GC are observed in Republic of Tyva: the ASR of incidence in this region is 24.56 per 100,000 population, and the ASR of mortality is 18.75 per 100,000 population. Population screening programs for GC, implemented in only two countries in the world (South Korea and Japan), have significantly increased the five-year survival rate for GC in these countries to 68.9% and 60.3%, respectively, while in the USA and Russia this figure is 33.1% and 21%, respectively. The leading method of population and opportunistic screening of GC in the world and in Russia is endoscopy in individuals over 50 years of age. For opportunistic and population screening, it is recommended to use esophagogastroscopy in individuals over 50 years of age once every 3 years and serological tests to determine the level of pepsinogens I and II, and IgG to Helicobacter pylori. High rates of morbidity and mortality from GC in Russia, low five-year survival rate determine the relevance of the development and implementation of a national strategy for population screening of GC.

Gastric cancer has emerged as a prominent cause of mortality in individuals with primary antibody deficiencies (PAD), especially common variable immunodeficiency (CVID), however its pathogenesis remains still poorly understood. Helicobacter (H.) pylori contributes to gastric cancerrisk in PAD, warranting early detection and eradication strategies. Prevention measures and screening programmes are still debated. This review provides an overview of recent advances in the field and discusses future perspectives. Over the last years, several papers have focused on the epidemiology, pathology, and treatment related to the high incidence and mortality of gastric cancer in PAD. Histological findings support the role of H. pylori as a key contributor, warranting early detection and eradication strategies. Immune dysregulation and genetic susceptibility have also been shown to contribute to the increased risk. H. pylori screening and treatment, along with endoscopic surveillance to identify premalignant and early malignant lesions, are widely recommended. In recent years, a decline in gastric cancer mortality has been observed in patients with CVID, paralleling trends in the general population, reflecting improved H. pylori management and enhanced surveillance. Gastric cancer surveillance is a priority in PAD. Further research should clarify pathogenesis, identify reliable biomarkers for risk stratification, and to define optimal surveillance strategies, ultimately improving early diagnosis and survival.

Abstract Background The macrolide clarithromycin has emerged as the most important antibiotic in combined therapy for eradication of Helicobacter pylori (H. pylori) infection. The eradication of H. pylori has been shown to reduce the incidence of gastric cancer. However, concerns about increasing clarithromycin resistance in H. pylori and its impact on the efficacy of eradication therapy have been raised since its widespread acceptance in H. pylori therapy. The global clarithromycin resistance rates are various among patient groups according to sex, age and geographic location. There are a few research analyzing specimens from local clinics and hospitals using molecular methods. Here, we sought to assess the clarithromycin resistance rates across sex, age groups as well as to explore regional variation in korea. Methods We collected 4040 gastric biopsies or tissue from 50 local clinics or hopsitals for molecular detection of H. pylori and clarithromycin resistance rate using 23s ribosomal RNA genes from Jan 2022 to Oct 2024. We analyzed the prevalence of clarithromycin resistance rates and investigated the patient*s age, sex, and regional distribution in Korea for the A2042G and A2043G mutations related to clarithromycin resistance. Results Clarithromycin resistance rate accounted for 32.4% of the total 4,040 patients, with 40.1% in women and 25.7% in men. Among the mutation types, A2143G showed a higher frequency than A2142G in both men and women. The resistance rate was higher in women than in men. In particular, the resistance rate showing the A2143G mutation in women increased every year. The clarithromycin resistance rate by age showed that the frequency of the A2143G mutation in women was over 40% in their 40s and 70s, and the mutation in A2142G gradually increased with age. In men, the frequency of the A2143G mutation was over 30% in the 20s and 80s and older. All five patients in their teens showed the A2143G mutation. Regional clarithromycin resistance rates showed a frequency of over 40% in Kyungsang, Seoul, and Chungcheong in women, and a frequency of over 40% in Pusan and Kyungsang in men. Conclusion In Korea, the clarithromycin resistance rate of Helicobacter pylori found in gastric tissues in men and women from 2022 to 2024 showed a high frequency of 32.4% on average. The mutation frequency was higher in women than in men, and the A2143G mutation showed a higher frequency than the A2142G mutation. In particular, the frequency of A2142G in women tended to increase every year. The frequency showed differences by age and region. When treating Helicobacter pylori, it is necessary to pay attention to the treatment outcome and the occurrence of resistance by referring to the clarithromycin resistance rate.

The increasing incidence of gastric cancer and the complexity of histopathological image interpretation present significant challenges for accurate and timely diagnosis. Manual assessments are often subjective and time-intensive, leading to a growing demand for reliable, automated diagnostic tools in digital pathology. This study proposes a hybrid deep learning approach combining convolutional neural networks (CNNs) and Transformer-based architectures to classify gastric histopathological images with high precision. The model is designed to enhance feature representation and spatial contextual understanding, particularly across diverse tissue subtypes and staining variations. Three publicly available datasets—GasHisSDB, TCGA-STAD, and NCT-CRC-HE-100 K—were utilized to train and evaluate the model. Image patches were preprocessed through stain normalization, augmented using standard techniques, and fed into the hybrid model. The CNN backbone extracts local spatial features, while the Transformer encoder captures global context. Performance was assessed using fivefold cross-validation and evaluated through accuracy, F1-score, AUC, and Grad-CAM-based interpretability. The proposed model achieved a 99.2% accuracy on the GasHisSDB dataset, with a macro F1-score of 0.991 and AUC of 0.996. External validation on TCGA-STAD and NCT-CRC-HE-100 K further confirmed the model’s robustness. Grad-CAM visualizations highlighted biologically relevant regions, demonstrating interpretability and alignment with expert annotations. This hybrid deep learning framework offers a reliable, interpretable, and generalizable tool for gastric cancer diagnosis. Its superior performance and explainability highlight its clinical potential for deployment in digital pathology workflows.

BackgroundDespite a global decline in gastric cancer (GC) incidence, nondistal GC (NDGC) is increasingly prevalent among younger patients, necessitating targeted investigation of early-onset NDGC (EONDGC) to identify prognostic determinants for enhanced risk stratification.MethodsEONDGC patients were identified from multiple datasets, including the Surveillance, Epidemiology, and End Results (SEER) database, the Cancer Genome Atlas (TCGA) Stomach Adenocarcinoma cohort, and the Affiliated Hospitals of Sun Yat-sen University (SYSU) as an external validation cohort. Propensity score matching was performed to reduce baseline differences between groups. A prognostic model was developed using univariate and multivariate Cox regression and LASSO analysis in a 7:3 training–validation split. The prognostic model was applied to TCGA patients to generate risk scores, and high-risk patients were selected for differentially expressed genes (DEGs) analysis. The identified genes were then analyzed using Cox regression and Kaplan-Meier methods to determine prognostic relevance. In parallel, MGC-803 and AGS cells were transiently transfected to overexpress ARSB; RT-qPCR verification, scratch and transwell migration assays quantified motility.ResultsA total of 535 EONDGC patients from SEER and 171 from SYSU were included. The prognostic model, incorporating seven clinical variables (race, pathological grade, T, N, and M stage, lymph node ratio, and chemotherapy), achieved robust performance with concordance index values of 0.758 (training), 0.718 (validation), and 0.762 (SYSU), with all AUCs > 0.75. In the TCGA patients, 73 upregulated genes were identified from high-risk patients through DEGs analysis. Among these, ARSB and PDCD1 were determined to be independent prognostic markers based on Cox and Kaplan-Meier analyses. Furthermore, a higher ARSB/PDCD1 ratio (APR) was associated with poorer overall survival (P = 0.041). In vitro, ARSB overexpression increased scratch migration area and transwell-migrated cell counts versus empty vector.ConclusionThis study developed a clinical prognostic model for EONDGC and therefore identified ARSB and PDCD1 as key molecular markers. The APR value enhances survival stratification, offering valuable insights into personalized prognosis and potential immunotherapy strategies.

BackgroundGastric cancer (GC) is one of the most common malignant tumors worldwide, with approximately one million people diagnosed with gastric cancer each year. Although the incidence and mortality rates of gastric cancer have decreased in recent years, it remains the third leading cause of cancer-related deaths globally. Fomes officinalis Ames (FOA), also known as A LI HONG or deciduous matsutake, the dried fruiting body of medicinal polypore fungus belongs to the Polyporaceae family. It is traditionally used in Chinese medicine to relieve coughs and asthma, dispelling wind and dampness, reducing swelling, and alleviating pain. However, the role of FOA in the treatment of gastric cancer remains unknown. This study systematically elaborates on the therapeutic effect of FOA triterpenic acids on human gastric cancer MKN-45 cells, providing a theoretical basis for their development as natural-sourced anti-tumor drugs. Future research could further explore their molecular targets, tap into the application value of FOA triterpenic acids in the comprehensive treatment of GC, and offer new strategies for the integrated traditional Chinese and Western medicine treatment of GC.MethodsIn this study, a network pharmacology approach was employed to identify relevant targets from drug and disease-related databases. The five active components of FOA were retrieved from the Swiss Target Prediction (http://www.swisstargetprediction.ch/) database, and 379 drug active component targets were predicted. A total of 14,092 gastric cancer targets were retrieved from the GeneCards (https://www.genecards.org/) database using the keyword “gastric cancer”. Venny 2.1 was used to analyze the intersections, and a protein-protein interaction (PPI) network was constructed. The PPI network contains 328 nodes and 4,486 edges. Core targets were visualized and analyzed using Cytoscape software. Subsequently, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were conducted to elucidate the associated biological functions and signaling pathways. Meanwhile, molecular docking of core targets with the main chemical components of FOA was performed using AutoDock software. Finally, in vitro experiments were conducted using human gastric cancer MKN-45 cells to validate the findings.ResultsNetwork pharmacology and molecular docking studies have shown that the triterpenic acid components in FOA exhibit strong molecular binding affinity with the core targets CASP3 and EGFR. They also predict that FOA may exert anti-gastric cancer effects by regulating pathways such as neuroactive ligand-receptor interaction and cancer-related pathways. Additionally, a method for extracting and purifying FOA triterpenic acids was successfully established, with its methodological validation meeting the required standards; chromatographic peaks of triterpenic acid indicator components were observed at the corresponding retention times (4.37 min, 16.71 min). In vitro experiments demonstrated that Fomitopsis officinalis polysaccharides and triterpenic acids could significantly inhibit the proliferation of gastric cancer cells. The IC50 after 24 h and 48 h of treatment were 41.26 μg/mL and 16.21 μg/mL, respectively. These components arrested the gastric cancer cell cycle at the G1, inhibited cell migration and invasion, and induced cell apoptosis by activating CASP3. All these findings further highlight the potential application value of FOA in gastric cancer treatment.

Gastric cancer is one of the most common cancers worldwide. It is associated with high mortality risk. Helicobacter pylori (H. pylori) is a major significant risk factor for gastric cancer, as its virulence factors significantly contribute to gastric carcinogenesis. H. pylori eradication has been associated with reduced incidence of gastric cancer. H. pylori mechanisms in achieving long-term and sustained cancer prevention remain unclear. The aim of this review is to explore the effectiveness and mechanisms of H. pylori in gastric cancer prevention. H. pylori contribute to gastric cancer by molecular mechanisms, such as activating the NF-κB pathway, and cellular mechanisms, such as oxidative stress. Studies have shown that H. pylori eradication reduced the incidence of gastric cancer in healthy populations and patients with early gastric cancer undergoing endoscopic mucosal resection. H. pylori vaccination can be an effective method in the prevention of H. pylori infection, thus preventing gastric cancer. Future studies should develop an integrated approach combining targeted eradication, microbiome management, and innovative vaccination strategies to prevent the occurrence of gastric cancer.

The epidemiological data on the incidence of gastric cancer and its mortality make it a challenge for oncologists to find new and improve existing diagnostic methods and therapies. Despite the active change of modern realities in the practice of pathomorphologist for 60 years remains unchanged authority of the P.Laurén classification of histological main types. This does not leave it without attention from the scientists of our time, so there are published works refuting or confirming its prognostic significance, as well as studies in which its modifications are proposed. In this regard, the purpose of this review is to briefly systematise the currently available information on P.Laurén classification and to provide an opportunity to review the content of the original article by Pekka Laurén in Russian.

The incidence, prevalence and survival rates of gastric cancer are high, and the prognostic effects of healthy behaviors among survivors have not been well investigated. Therefore, We aimed to assess the effects of postdiagnosis healthy behaviors and behavior changes after gastric cancer diagnosis on all-cause mortality. As a population-based retrospective cohort study, we used a cancer public library sample DB of gastric cancer patients between 2012 and 2019. Information from regular health check-up examinations were used to investigate their anthropometric measures, physical activities, alcohol consumption, and smoking status before and after cancer diagnosis. Hazard ratios (HRs) for all-cause deaths with 95% confidence intervals (CIs) were estimated via the Cox proportional hazards model. We analyzed 9,717 gastric cancer patients and 5,929 of those as a subgroup to assess the effects of behavior changes. Reduced mortality was shown among cancer patients who met the recommended criteria after the cancer diagnosis for physical activity (adjusted HR = 0.67 [95% CI=0.49-0.93], mean frequencies of moderate to vigorous physical activity per week: ≥5 days vs. 0 days) and smoking cessation (0.77 [0.61-0.97], smoking status: never-smokers vs. current smokers). Participants who reported enhancement in behaviors had significantly lower mortality than the others who reported no or limited changes in physical activity (0.73 [0.55-0.96]) and smoking status (0.56 [0.38-0.83]). The current study highlights the advantages of physical activity and smoking cessation in reducing mortality, and these benefits are even greater when patients improve their behavior after cancer diagnosis.

PurposeGastric perforation remains a life-threatening condition despite advances in medical therapies and surgical techniques. In clinical emergencies involving gastric perforation, distinguishing between benign and malignant etiologies remains uncertain until histological confirmation is obtained.MethodsThis study analyzed 79 patients who underwent emergency gastrectomy for gastric perforation between 2010 and 2024. Patients were categorized into ulcer and cancer groups based on pathological findings. Clinical data, including preoperative conditions and postoperative outcomes, were analyzed using univariate and multivariate analyses.ResultsElderly (aged ≥75 years), symptom duration ≥48 hours, and American Society of Anesthesiologists physical status classification IV-E were significant risk factors for postoperative mortality. The cancer group had longer operation times, while ventilator use was more common in the ulcer group. No significant differences were observed in overall mortality rates.ConclusionEmergency gastrectomy can be a viable treatment for gastric perforation in regions with a high incidence of gastric cancer. However, patients with advanced age, delayed symptom onset, or poor physical status require careful surgical planning. Tailored strategies may improve outcomes, particularly in high-incidence regions for gastric cancer.

Juglone targets MMP-1 to inhibit gastric cancer progression.

Background: The incidence of early-onset gastric cancer (EOGC) has been steadily increasing in recent years. However, the efficacy of adjuvant chemotherapy (AC) in this population remains unclear. This study aimed to investigate the clinicopathological characteristics, survival outcomes, and efficacy of AC between EOGC and average-onset gastric cancer (AOGC) patients. Methods: Patients with stage II-III gastric adenocarcinomas who underwent curative D2 gastrectomy at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2014 to December 2021 were enrolled and classified into two groups: EOGC (≤45 years) and AOGC (>45 years) groups. Clinicopathological characteristics, overall survival (OS), and efficacy of AC were compared between the two groups. Western and East Asian cohorts were included as external validation sets to compare the efficacy of AC between different age groups. Results: Compared to AOGC, EOGC patients exhibited a higher proportion of females, poor differentiation, diffuse Lauren type, middle-third GC, perineural invasion (PNI), and receipt of AC. Univariate and multivariate analyses identified that T stage, N stage, PNI, and AC were independent prognostic factors for OS. After balancing the baseline characteristics between patients who received AC and those who did not, the Kaplan-Meier survival curves indicated that AC significantly improved OS across all patients. Further subgroup analysis revealed a survival benefit of AC in AOGC patients, whereas no significant survival difference was observed in the EOGC subgroup. Consistently, external validation in both Western and East Asian cohorts confirmed that AC did not confer a survival advantage in EOGC patients. Conclusions: EOGC exhibits aggressive pathological characteristics, and chemotherapy does not consistently improve survival in EOGC patients.

Proteinuria, a marker of renal dysfunction, has been implicated in cancer risk, yet its role in gastric carcinogenesis remains underexplored in high-incidence populations. This study evaluated the association between urine dipstick proteinuria severity and gastric cancer incidence in a nationwide Korean cohort. We analyzed data from the Korean National Health Insurance Service-National Sample Cohort, including 220,941 adults aged > 40 years, without a diagnosis of cancer, who received health examinations in 2009. Proteinuria was classified by single dipstick testing as negative, 1+, or ≥2+. Participants were followed for a mean of 4.37 ± 0.49 years (965,601.2 person-years). Multivariable Cox proportional hazards models adjusted for age, sex, body mass index, systolic blood pressure, fasting glucose, LDL cholesterol, estimated glomerular filtration rate, smoking status, alcohol intake, and physical activity were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During follow-up, 1934 participants (0.88%) developed gastric cancer. A significant dose-response relationship emerged (p for trend = 0.037). In fully adjusted models, 1+ proteinuria conferred no significant risk increase (HR 1.10; 95% CI, 0.80-1.51), whereas ≥2+ proteinuria was associated with a 42% higher gastric cancer risk (HR 1.42; 95% CI, 1.00-2.02). Severe dipstick proteinuria independently predicts elevated gastric cancer risk in Korean adults. Integration of urine dipstick testing into gastric cancer screening protocols may offer a simple, cost-effective strategy for risk stratification, particularly in high-incidence settings.

Eastern Asia has historically had the highest global incidence and mortality rates of gastric cancer (GC) while substantial disparities exist between countries. The overall burden of GC remains insufficiently explored. Using the Global Burden of Disease Study 2021, this research aims to estimate the burden and risk factors of GC in Eastern Asia from 1990 to 2021. Incidence, age-standardized incidence rate (ASIR), deaths, age-standardized mortality rate (ASMR), disability-adjusted life years, age-standardized disability-adjusted life year rate (ASDR), and risk factor burdens for GC were analyzed in Eastern Asia from 1990 to 2021. Joinpoint analysis determined average annual percent change (AAPC) and annual percent change, while age-period-cohort analysis assessed temporal trends. The Bayesian age-period-cohort model projected GC burden from 2021 to 2035. All analyses used R software (version 4.4.1; R Foundation for Statistical Computing). In 2021, Eastern Asia reported 748,235 new GC cases and 527,054 deaths, accounting for 60.8% (748,235/1,230,232) of new cases and 55.2% (527,054/954,373) of deaths reported globally. From 1990 to 2021, South Korea showed the largest declines in ASIR, ASMR, and ASDR, with ASMR decreasing from 55.4 per 100,000 to 13.3 per 100,000 (AAPC -4.5, 95% CI -4.8 to -4.3). ASIR, ASMR, and ASDR also showed a downward trend in Japan and China, with an AAPC of -3.0 (95% CI -3.2 to -2.8) for ASMR in Japan and -2.4 (95% CI -2.6 to -2.3) in China. The GC burden of North Korea was basically stable, with an AAPC of ASMR of -0.8 (95% CI -0.8 to -0.8). Mongolia showed a slight decline, with an AAPC of ASMR of -1.4 (95% CI -1.7 to -1.0), and the burden of GC was the highest. High-sodium diets and smoking were the main risk factors for disability-adjusted life years of GC in 2021. Smoking contributed to a decline in ASDR as the sociodemographic index increased. Projections suggest continued ASDR reductions across Eastern Asia from 2022 to 2035, though Mongolia will maintain the highest burden. Despite a decrease from 1990 to 2021, GC remains a significant public health issue in Eastern Asia. Addressing it necessitates prioritizing primary and secondary prevention, including reducing risk factors and enhancing early screening.

The incidence of early-onset gastric, esophageal, and colorectal cancers has increased rapidly in the United States over the past two decades. Genetic predisposition, environmental exposures, and lifestyle factors contribute to these trends, particularly among Hispanic and East Asian patients. This study examines epidemiologic influences underlying this growing burden. Recent research highlights genetic susceptibilities, environmental exposures, and dietary habits, such as higher Helicobacter pylori prevalence and cancer-associated polymorphisms, as key risk factors. Hispanic patients experience younger-onset gastric cancer and higher rates of noncardia gastric and advanced-stage colorectal cancers. Additionally, studies highlight East Asia as a region with some of the highest rates of gastrointestinal (GI) cancer incidence and mortality. Although the specific incidence among early-onset cases remains relatively understudied, preliminary evidence suggests an increasing trend in early-onset GI cancers in this region. Despite advancements in targeted therapies, young patients face higher cancer-specific mortality. The increasing Hispanic and East Asian populations in the United States may contribute to increasing early-onset GI malignancies because of their unique genetic and environmental susceptibilities. This study is the first to explore the connection between demographic shifts and increasing cancer incidence in young Hispanic and East Asian populations. Further research is needed to better characterize and mitigate these concerning trends.

BackgroundWhile global gastric cancer incidence has declined, trends in early-onset gastric cancer (EOGC, age 15-49) remain unclear. This study evaluates EOGC’s global burden (1990-2021), projects trends to 2030, and identifies epidemiological drivers.MethodsUsing Global Burden of Disease (GBD) 2021 data, we analyzed age-standardized incidence, mortality, disability-adjusted life years (DALYs), and estimated annual percentage change for EOGC globally and by sex, region, and income level. A Bayesian age-period-cohort model and decomposition analysis assessed temporal trends, epidemiological drivers (eg, aging, population growth), and projected burden through 2030.ResultsIn 2021, EOGC caused 125 120 new cases and 78 871 deaths globally. From 1990 to 2021, age-standardized mortality, incidence, and DALYs declined worldwide. East Asia and high-middle-income regions bore the highest burden. Decomposition identified epidemiological changes as the primary driver of reduced EOGC burden. Males exhibited higher incidence, mortality, and DALYs than females. Projections suggest declining incidence and mortality rates by 2030 for both sexes, yet rising absolute case numbers due to population growth.ConclusionsEarly-onset gastric cancer burden shows complex patterns: while rates have decreased over 3 decades, absolute cases and deaths increased due to demographic expansion. Disparities persist across gender, geography, and development levels. These findings highlight the need for targeted interventions in high-risk populations and regions to address inequities. Policymakers should prioritize surveillance and prevention strategies tailored to evolving epidemiological trends.

Exploring temporal trends and influencing factors for upper digestive tract cancers in Guangzhou, China: 2010-2020.

Screening for, and treating, Helicobacter pylori in the general population or patients with early gastric neoplasia could reduce incidence of, and mortality from, gastric cancer. We updated a meta-analysis of randomized controlled trials (RCTs) examining this issue. We searched the literature through October 4, 2024, identifying studies examining effect of eradication therapy on incidence of gastric cancer in H pylori-positive adults without gastric neoplasia at baseline or H pylori-positive patients with gastric neoplasia undergoing endoscopic mucosal resection (EMR) in either RCTs or observational studies. The control arm received placebo or no eradication therapy in RCTs and no eradication therapy in observational studies. Follow-up was ≥2 years. We estimated relative risks (RR) of gastric cancer incidence and mortality. Eleven RCTs and 13 observational studies were eligible. For RCTs, RR of gastric cancer was lower with eradication therapy in healthy H pylori-positive individuals (8 RCTs, 0.64; 95% confidence interval [CI], 0.48-0.84) and H pylori-positive patients with gastric neoplasia undergoing EMR (3 RCTs, 0.52; 95% CI, 0.38-0.71). RR of death from gastric cancer was lower with eradication therapy in healthy H pylori-positive individuals (5 RCTs, 0.78; 95% CI, 0.62-0.98). In observational studies, RR of future gastric cancer was lower with eradication therapy in H pylori-positive subjects without gastric neoplasia at baseline (11 studies, 0.56; 95% CI, 0.43-0.73) and H pylori-positive patients with gastric neoplasia undergoing EMR (2 studies, 0.19; 95% CI, 0.06-0.61). This meta-analysis provides further evidence that administering eradication therapy prevents gastric cancer in H pylori-positive individuals, with consistency in results among studies of different design.

Exosomal SLC1A5 from senescent endothelial cells promotes gastric cancer progression by dampening ferroptosis via the EGFR/SRC/YAP1/GPX4 signaling.