Helicobacter pylori is a recognized cause of stomach cancer, but only a fraction of infected subjects develop cancer. 

Dr Kimberly Venneman and colleagues summarize the prevalence of infection with this bacterium in Europe, and review the possible impact of particular lifestyles in progression from infection to stomach cancer.

A systematic literature search was conducted in two databases by two independent investigators. 

Studies describing prevalence of infection among European healthy adult populations and worldwide studies analyzing the impact of lifestyle factors in association with Helicobacter pylori on stomach cancer risk were included. 

Variable Helicobacter pylori infection prevalence was observed depending on region and study period. 

The lowest infection prevalences were found in Northern Europe, while the highest were in Eastern and Southern Europe, up to 84% in Portugal and Poland. 

Studies on smoking, salt, and meat consumption demonstrated increased risks of developing stomach cancer among Helicobacter pylori‐infected individuals, while studies relating the intake of fruit, vegetables, and vitamins demonstrated decreased risks, but the levels of significance differed importantly between studies. 

The researchers found no significant interaction for alcohol consumption or physical activity.

Dr Venneman's team concludes, "Recent data showed remaining high Helicobacter pylori infection rates in several European regions."

"This systematic review suggests that a number of correctable lifestyle factors could impact the disease progression toward Helicobacter pylori‐associated stomach cancer."

"However, additional research is required to determine the potential role of targeted interventions in reducing stomach cancer development after Helicobacter pylori infection."