학술논문
The Association between Helicobacter pylori and Colorectal Neoplasia
Document Type
Report
Author
Source
Medical Principles and Practice. June 2023, Vol. 32 Issue 1, p77, 9 p.
Subject
Language
English
Abstract
Author(s): Sarah Wernly [a]; Georg Semmler [b]; Maria Flamm [c]; Richard Rezar [d]; Elmar Aigner [e]; Christian Datz [a]; Bernhard Wernly [a,c] Highlights of the Study * H. pylori is [...]
Objectives: Helicobacter pylori (H. pylori) and colorectal neoplasia (CRN) are frequent entities. Epidemiological data suggest an association between H. pylori positivity (H. pylori +) and CRN, whereas pathophysiologic considerations substantiate a possible causal relationship. However, the relationship between CRN and H. pylori + may also be mediated by shared risk factors. Therefore, the aim of this cross-sectional study was to evaluate a possible independent relationship between H. pylori and CRN in a Central European cohort. Methods: We included 5,707 asymptomatic patients. All patients underwent screening colonoscopy and upper gastrointestinal endoscopy. We assessed the association between any CRN and advanced CRN with H. pylori + using multilevel logistic regression. We adjusted for age, sex, a positive family history of colorectal cancer, and cardiovascular risk. Results: 1,082 patients (19%) were H. pylori + and 4,625 (81%) H. pylori . Patients with both CRN and H. pylori had more cardiometabolic risk factors. In univariate (aOR 1.20; 1.10-1.31) and multivariable analysis (aOR 1.20; 1.08-1.32), H. pylori + was associated with the diagnosis of any CRN. However, H. pylori + was associated with the presence of advanced CRN (aOR 1.26; 0.96-1.64) only in trend. Conclusions: We found a clustered co-occurrence of CRN and H. pylori. This association persisted after correction for shared cardiometabolic risk factors. We suggest that our analysis emphasizes the clinical value of H. pylori eradication. Whether 'test and treat' H. pylori is warranted to prevent CRN remains unclear but is at least a possibility given the simplicity of 'test and treat.' Keywords: Helicobacter pylori, Colorectal neoplasms, Cancer screening, Metabolic syndrome
Objectives: Helicobacter pylori (H. pylori) and colorectal neoplasia (CRN) are frequent entities. Epidemiological data suggest an association between H. pylori positivity (H. pylori +) and CRN, whereas pathophysiologic considerations substantiate a possible causal relationship. However, the relationship between CRN and H. pylori + may also be mediated by shared risk factors. Therefore, the aim of this cross-sectional study was to evaluate a possible independent relationship between H. pylori and CRN in a Central European cohort. Methods: We included 5,707 asymptomatic patients. All patients underwent screening colonoscopy and upper gastrointestinal endoscopy. We assessed the association between any CRN and advanced CRN with H. pylori + using multilevel logistic regression. We adjusted for age, sex, a positive family history of colorectal cancer, and cardiovascular risk. Results: 1,082 patients (19%) were H. pylori + and 4,625 (81%) H. pylori . Patients with both CRN and H. pylori had more cardiometabolic risk factors. In univariate (aOR 1.20; 1.10-1.31) and multivariable analysis (aOR 1.20; 1.08-1.32), H. pylori + was associated with the diagnosis of any CRN. However, H. pylori + was associated with the presence of advanced CRN (aOR 1.26; 0.96-1.64) only in trend. Conclusions: We found a clustered co-occurrence of CRN and H. pylori. This association persisted after correction for shared cardiometabolic risk factors. We suggest that our analysis emphasizes the clinical value of H. pylori eradication. Whether 'test and treat' H. pylori is warranted to prevent CRN remains unclear but is at least a possibility given the simplicity of 'test and treat.' Keywords: Helicobacter pylori, Colorectal neoplasms, Cancer screening, Metabolic syndrome