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Incidence of chronic atrophic gastritis: systematic review and meta-analysis of follow-up studies

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Abstract

Chronic atrophic gastritis (CAG) is an important precursor lesion of intestinal gastric cancer. As it is typically asymptomatic, epidemiological data on the incidence of CAG are sparse. We aimed to provide an overview of published data on CAG incidence (overall and according to risk factors) from follow-up studies. Articles with information on incidence of CAG published in English until 26th of July 2009 were identified through a systematic MEDLINE and EMBASE search. Data extracted include study characteristics and key findings regarding the incidence of CAG. A meta-analysis was performed on the association between Helicobacter pylori infection and CAG incidence. Overall, data on CAG incidence were available from 14 studies, in 7 studies incidence could be estimated according to H. pylori infection. Most studies were conducted in symptomatic or high risk populations and the maximum number of incident cases was 284. Incidence estimates ranged from 0 to 11% per year and were consistently below 1% in patients not infected with H. pylori. The highest incidence was observed in a special study conducted on ulcer patients treated by proximal gastric vagotomy. Rate ratios for the association between H. pylori infection and CAG incidence ranged from 2.4 to 7.6 with a summary estimate of 5.0 (95% confidence interval: 3.1–8.3). Incidence of CAG is very low in the absence of H. pylori infection. There is a need for more population-based studies to provide comparable estimates of incidence and the impact of risk factors in the development of CAG.

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Abbreviations

CAG:

Chronic atrophic gastritis

cagA:

Cytotoxin associated gene A

H. pylori :

Helicobacter pylori

PG:

Pepsinogen

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Acknowledgements

This work was supported by a grant from the Baden-Württemberg State Ministry of Research, Science and Arts. The work of Gao Lei was supported by a scholarship from the German Academic Exchange Service.

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Authors and Affiliations

  1. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Bergheimer Str. 20, 69115, Heidelberg, Germany

    Mariam Abdullahi Adamu, Melanie Nicole Weck, Lei Gao & Hermann Brenner

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  1. Mariam Abdullahi Adamu
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  2. Melanie Nicole Weck
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  3. Lei Gao
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  4. Hermann Brenner
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Correspondence to Hermann Brenner.

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Adamu, M.A., Weck, M.N., Gao, L. et al. Incidence of chronic atrophic gastritis: systematic review and meta-analysis of follow-up studies. Eur J Epidemiol 25, 439–448 (2010). https://doi.org/10.1007/s10654-010-9482-0

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