caa a22 4500 445315245 CHVBK 20180317142644.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1007/s10552-010-9707-2 doi (NATIONALLICENCE)springer-10.1007/s10552-010-9707-2 Helicobacter pylori infection and gastric cardia cancer: systematic review and meta-analysis [Elektronische Daten] [Marlene Cavaleiro-Pinto, Bárbara Peleteiro, Nuno Lunet, Henrique Barros] Objective: Helicobacter pylori infection is the most important risk factor for gastric cancer, but no association with cardia cancer has been recognized. However, a heterogeneous distribution of etiologically distinct types of cardia cancer may contribute to explain conflicting findings between studies in high- and low-risk settings. We aimed to quantify the association between H. pylori infection and gastric cardia cancer through meta-analysis, and to provide an explanation for the expected heterogeneity of results. Methods: We systematically reviewed published studies addressing the association between H. pylori infection and gastric cardia cancer (up to June 2009), and extracted relative risk (RR) estimates for the association with cardia and non-cardia cancers. Summary RR estimates and 95% confidence intervals (95% CI) were computed using random-effects models. Subgroup analyses were conducted, namely according to gastric cancer risk settings. Results: Thirty-four articles were considered for meta-analysis. For cardia cancer, summary RR was 1.08 (95% CI 0.83-1.40; I 2=52.8%), higher in high-risk (RR=1.98; 95% CI 1.38-2.83; I 2=18.4%) than in low-risk settings (RR=0.78; 95% CI 0.63-0.97; I 2=11.6%). For non-cardia cancer, RR estimates were similar in high- (RR=3.02; 95% CI 1.92-4.74; I 2=90.7%) and low-risk settings (RR=2.56; 95% CI 1.99-3.29; I 2=46.6%). These observations were consistent across different inclusion criteria and when accounting for the virulence of the infecting strains. Conclusions: In high-risk settings, a positive association between H. pylori infection and gastric cancer was observed both for cardia and non-cardia cancers. The results support the hypothesis of a heterogeneous distribution of etiologically distinct types of cardia cancer. Springer Science+Business Media B.V., 2010 Helicobacter pylori nationallicence Cardia nationallicence Stomach neoplasms nationallicence Systematic review nationallicence Meta-analysis nationallicence Cavaleiro-Pinto Marlene Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal aut Peleteiro Bárbara Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal aut Lunet Nuno Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal aut Barros Henrique Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal aut Cancer Causes & Control Springer Netherlands 22/3(2011-03-01), 375-387 0957-5243 22:3<375 2011 22 10552 https://doi.org/10.1007/s10552-010-9707-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10552-010-9707-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Cavaleiro-Pinto Marlene Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal aut NATIONALLICENCE 700 1- Peleteiro Bárbara Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal aut NATIONALLICENCE 700 1- Lunet Nuno Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal aut NATIONALLICENCE 700 1- Barros Henrique Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal aut NATIONALLICENCE 773 0- Cancer Causes & Control Springer Netherlands 22/3(2011-03-01), 375-387 0957-5243 22:3<375 2011 22 10552 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer