Helicobacter pylori and pancreatic cancer risk: a meta- analysis based on 2,049 cases and 2,861 controls

Helicobacter pylori (H. pylori) have been considered as a risk factor for many cancers. We conducted this meta-analysis to clarify the association between H. pylori infection and the risk of pancreatic cancer.

We searched the Medicine/Pubmed and Embase databases, studies about the association between H. pylori infection and pancreatic cancer published up to Jan.2014 were included. Finally, a total of 9 studies were used for this a meta-analysis. The odds ratios (ORs) and 95% confidence interval (95%CI) of H. pylori infection on pancreatic cancer with respect to control groups were evaluated. Two authors independently assessed the methodological quality and extracted data. This meta-analysis was conducted using software, state (version 12.0) to investigate heterogeneity among individual studies and to summarize the studies. Using the fixed-effects or random-effects model, depending on the absence or presence of significant heterogeneity. Sensitivity analysis was performed to assess the influence of each individual study on the pooled ORs by omitting a single study each time. Publication bias was evaluated by funnel plot, using Egger's and Begg's tests.

There was no significant association between H. pylori infection and pancreatic cancer risk in the summary ORs,(OR=1.06, 95%CI: 0.74-1.37) through the random-effect method, but heterogeneity among studies was significant (I2=58.9%), so we put the studies into two subgraphs (eastern and western). The results about western (OR=1.14 95%CI:0.89, 1.40) showed heterogeneity among the western countries of I2=6.6%, with no significant association between Hp+ and pancreatic cancer, but the eastern countries (OR=0.62, 95%CI:0.49, 0.76), I2=0, suggested that decreasing pancreas-cancer risk in subjects with Hp+ infection. Simultaneously, 7 studies examined CagA+ strains was (OR=0.84 95%CI:0.63, 1.04), I2=36% with the random-effect method, subgraphs indicated that CagA+ could decrease the risk of pancreatic cancer in the eastern subjects (OR=0.66, 95%CI:0.52-0.80), but the association was not statistically significant in the western subjects (OR=0.95, 95%CI:0.73, 1.16).

Hp+ and CagA+ infection are associated with a decreased risk of pancreatic cancer in eastern populations but have no significant associations in western countries.