Atrophic Gastritis, <i>Helicobacter pylori</i>, and Colorectal Cancer Risk: A Case‐Control Study

Machida-Montani, Ai; Sasazuki, Shizuka; Inoue, Manami; Natsukawa, Shusuke; Shaura, Kozo; Koizumi, Yukio; Kasuga, Yoshio; Hanaoka, Tomoyuki; Tsugane, Shoichiro

doi:10.1111/j.1523-5378.2007.00513.x

Cited by 61 publications

(59 citation statements)

References 25 publications

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“…Several publications have reported that atrophic gastritis is not associated with increased CRC risk (25,26). Our study also found no statistically significant association in the risks of developing gastric atrophy in either the study or the control group (OR=1.24, p>0.05).…”

Section: Discussioncontrasting

confidence: 68%

Is there any association between colonic polyps and gastric intestinal metaplasia?

Unler¹,

Ozgur²,

Gokturk³

et al. 2016

Turk J Gastroenterol

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Section: Discussioncontrasting

confidence: 68%

Is there any association between colonic polyps and gastric intestinal metaplasia?

Unler¹,

Ozgur²,

Gokturk³

et al. 2016

Turk J Gastroenterol

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“…As for CAG, two reports have described non-significant results for the correlation between colorectal cancer and CAG (29,30). Our previous population-based case-control study comprising middle-aged male factory workers, which included adjustment for potential confounding factors, clearly demonstrated an increase in the risk of colorectal adenoma in the presence of H. pylori-associated chronic gastritis (7).…”

Section: Discussionmentioning

confidence: 75%

Elevated risk of recurrent colorectal neoplasia with Helicobacter pylori-associated chronic atrophic gastritis: A follow-up study of patients with endoscopically resected colorectal neoplasia

Inoue

Kato

Yoshimura

et al. 2012

Molecular and Clinical Oncology

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Abstract.In a previous population-based case-control study, we demonstrated an elevated risk of colorectal neoplasia with Helicobacter pylori (H. pylori) infection. The present study investigated the effects of H. pylori-associated chronic gastritis on the development of colorectal neoplasia by analyzing the recurrence of colorectal neoplasia subsequent to endoscopic resection. Ninety-nine patients who had undergone endoscopic resection of colorectal neoplasia were monitored under colonoscopy, and the recurrence of colorectal neoplasia was prospectively investigated. The stage of H. pylori-associated chronic gastritis in each subject was evaluated using a combination of two serum tests: H. pylori antibody and pepsinogen. In the present cohort, colorectal neoplasia recurred at a rate of 15,296/100,000 person-years during the study period. After adjusting for the confounding factors, chronic atrophic gastritis (CAG) was identified as an independent risk factor [adjusted hazard ratio (HR), 2.72; 95% confidence interval, 1.33-5.57], while H. pylori-infected non-atrophic gastritis was not identified as an independent risk factor for recurrent colorectal neoplasia. Colorectal neoplasia recurred earlier and was significantly more frequent in patients with CAG (22,573/100,000 person-years) compared to patients without CAG (11,089/100,000 person-years; P=0.029, log-rank test).Patients with more extensive CAG showed a higher risk of recurrence. These results demonstrated a significant elevation of the risk of recurrent colorectal neoplasia with the establishment and progression of CAG, indicating the involvement of H. pylori infection in the development of colorectal neoplasia. The two serum tests were useful clinical markers for noninvasively evaluating the risk of each individual for recurrent colorectal neoplasia subsequent to endoscopic resection.

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“…H. pylori in advanced gastric lesions has probably decreased because of migration through the gastrointestinal tract [55]. This suggests that with advanced gastric lesions, gastric lesions but not H. pylori status would be appropriate in the prediction of colorectal polyps [23,56,57]. Bulajic et al [24] found only 1.2% of malignant colorectal tissues were positive for H. pylori in contrast to 6% positive normal tissues from cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Gastric Helicobacter pylori infection associates with an increased risk of colorectal polyps in African Americans

et al. 2014

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BackgroundGastric Helicobacter pylori (H. pylori) infection and colorectal polyps are more prevalent in African Americans than in the general population. We aimed to investigate whether gastric H. pylori infection is associated with colorectal polyps in African Americans.MethodsMedical records of African Americans, 40 years and older (n = 1256) who underwent bidirectional gastrointestinal endoscopy on the same day were reviewed. H. pylori status was assessed by immunohistochemistry on gastric specimens. Colorectal polyps were confirmed by histological examination of colorectal biopsies. A subset of serum samples from healthy and polyp-bearing patients (n = 163) were analyzed by ELISA for anti-H. pylori and anti-CagA antibodies. The crude and adjusted effect of H. pylori on the risk of colorectal adenoma and polyp were computed by logistic regression models.ResultsThe prevalence of colorectal polyps and adenomas were 456 (36%) and 300 (24%) respectively. Colorectal polyps were more prevalent in gastric H. pylori infected than non-infected subjects [43% vs. 34%; Odds Ratio (OR) (95% CI): 1.5 (1.2-1.9), P = 0.001]. Patients with H. pylori-associated chronic active gastritis were at high risk to have adenomas [Unadjusted OR (95% CI): 1.3 (1.0-1.8); P = 0.04]. There was no difference in histopathology, size, or location of polyps with respect to H. pylori status. Gastric H. pylori infection, age, male gender and high risk clinical presentations were independent risk factors for colorectal polyps. Serological testing also revealed a higher prevalence of H. pylori and its toxin Cag-A in polyp patients vs. non polyp patients’ sera, although in a non-statistically significant manner.ConclusionsThis study showed that current gastric H. pylori infection is associated with an increased risk of colorectal polyps in African Americans. Patients with H. pylori induced gastritis may benefit from early screening colonoscopy as a preventative measure for colorectal cancer.

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Atrophic Gastritis, Helicobacter pylori, and Colorectal Cancer Risk: A Case‐Control Study

Abstract: Gastric conditions such as chronic H. pylori infection and atrophic gastritis are unlikely to increase the risk for CRC, although atrophic gastritis may increase the risk of rectal cancer.

Cited by 61 publications

References 25 publications

Is there any association between colonic polyps and gastric intestinal metaplasia?

Is there any association between colonic polyps and gastric intestinal metaplasia?

Elevated risk of recurrent colorectal neoplasia with Helicobacter pylori-associated chronic atrophic gastritis: A follow-up study of patients with endoscopically resected colorectal neoplasia

Gastric Helicobacter pylori infection associates with an increased risk of colorectal polyps in African Americans

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