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

Abstract

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.

Prediagnostic Helicobacter pylori Antibodies and Colorectal Cancer Risk in an Elderly, Caucasian Population

“…These differences in population characteristics may explain, at least in part, the discrepancies between our results and those of Epplein et al . Previous studies support the idea of differences by study population in the association between H. pylori and colorectal cancer as well as precursors such as polyps and adenomas .…”

Status of Epstein-Barr Virus Coinfection withHelicobacter pyloriin Gastric Cancer

“…H. pylori is a spiral-shaped bacterium that grows in the mucus layer which coats the inside of the human stomach, ultimately causing inflammation in the stomach called gastritis [62]. Further, it turns to ulcers [63, 64], long-lasting anaemia [65–67], and growths in the stomach [68, 69], which are more likely to get cancer. H. pylori is mainly spread through contaminated water, food, saliva, or mouth to mouth contacts and possibly transmitted sexually via oral-genital contact [70, 71].…”

Helicobacter pylori infection and increased diabetes prevalence were the risks of colorectal adenoma: a systematic review and meta-analysis

“…[3,6,8,9,19, Nineteen of them are cross-sectional studies [3, 6, 8, 19, 21-24, 25-28, 30, 31, 35, 37-40], and the remaining eight are case-control studies [9, 29, 32-34, 36, 41, 42]. Serology was utilized as the detection method for H. pylori in 14 studies [8, 9, 21, 23, 25-27, 31-35, 38, 39], pathology in 4 [3,22,40,42], UBT in 4 [6,37], CLO in 6 [19,24,30,36], and combining UBT and CLO in 2 [28,29] A flow chart describing the process of study selection is shown in Figure 1. For the meta-analysis, data were extracted from twenty-seven studies with a total of 68,410 patients, and the pooled OR for colorectal adenoma related to H. pylori infection was 1.51 (95% CI 1.39-1.63), although there was significant heterogeneity (p < 0.001) ( Table 1 and Figure 2).…”