Gastric intestinal metaplasia: Management and surveillance strategies

Table 2 Comparative analysis of key studies on Helicobacter pylori eradication and gastric cancer prevention

Ref.	Design	Population	Main findings	Strengths	Critique
Yan et al[45]	Randomized controlled trial	East Asian, high-risk cohort; 26.5-year follow-up	43% reduction in GC incidence; greatest benefit in early mucosal stages	Long-term follow-up; stratified analysis based on baseline histology	Single geographic region; changes in healthcare practices over decades may confound findings
Wu et al[42]	Updated meta-analysis	International with timing-specific focus	Eradication significantly reduces the risk of developing GC, with the greatest benefit observed in individuals who have previously undergone endoscopic resection for gastric neoplasia	Clarified time-dependence of eradication benefit; detailed sub-analyses	Publication bias risk; heterogeneous eradication protocols not standardized
Lee et al[46]	Prospective community intervention	Taiwanese general population	> 25% reduction in GC incidence post-eradication	Real-world mass intervention; extended follow-up	No randomized comparator group; confounded by improvements in screening and healthcare access
Kim et al[49]	Nationwide retrospective cohort	Korean patients post-endoscopic submucosal dissection	Early eradication (< 1 year) decreases metachronous cancer risk	Large sample size; timing stratification	Retrospective nature; surveillance bias; limited generalizability outside East Asia

GC: Gastric cancer.