Decreased Colorectal Adenoma Risk after Helicobacter pylori Eradication: A Retrospective Cohort Study
Journal
Clinical Infectious Diseases
Journal Volume
68
Journal Issue
12
Pages
2105-2113
Date Issued
2019
Author(s)
Hu K.-C.
Chu C.-H.
Wang H.-Y.
Lin S.-C.
Liu C.-C.
Shih S.-C.
Abstract
Background: Helicobacter pylori infection is associated with colorectal adenoma and confers a 1.3- to 2.26-fold increased risk. We evaluated the association between H. pylori and the progression of colorectal adenoma. Methods: This retrospective cohort study included 615 adults with no history of colorectal adenoma or cancer at baseline who participated in a repeated, regular health screening examination, which included a bidirectional gastrointestinal endoscopy, between July 2006 and June 2015. A gastric biopsy specimen from each subject was tested for H. pylori. Results: During follow-up, the incidence rates of colorectal adenoma progression in participants with persistent H. pylori infections (persistent group) and those whose infections had previously been successfully eradicated (eradication group) were 160.52 and 51.60 per 1000 person-years, respectively (P =. 0003). After adjustment for confounding factors, the persistent group exhibited a higher risk of colorectal adenoma than the eradication group (hazard ratio = 3.04, 95% CI 1.899, 5.864). The colorectal adenoma ratio of patients uninfected with H. pylori was similar to that of the eradication group (23.93% vs 20.12%, P =. 328). Conclusions: Persistent H. pylori infection was associated significantly with the independent development of colorectal adenoma. H. pylori infection may have a pathophysiological role in colorectal adenoma development and, after successful eradication of H. pylori, the colorectal adenoma ratio might decrease. ? 2018 The Author(s) 2018.
SDGs
Other Subjects
adenoma; adult; aged; colorectal tumor; complication; female; health survey; Helicobacter infection; Helicobacter pylori; human; incidence; Kaplan Meier method; male; microbiology; middle aged; proportional hazards model; retrospective study; risk assessment; risk factor; socioeconomics; Adenoma; Adult; Aged; Colorectal Neoplasms; Female; Helicobacter Infections; Helicobacter pylori; Humans; Incidence; Kaplan-Meier Estimate; Male; Middle Aged; Proportional Hazards Models; Public Health Surveillance; Retrospective Studies; Risk Assessment; Risk Factors; Socioeconomic Factors
Publisher
Oxford University Press
Type
journal article