Helicobacter pylori infection increases the risk of colorectal adenomas: cross-sectional study and meta-analysis.
BACKGROUND
The studies concerning the association between Helicobacter pylori status and colorectal adenoma, premalignant lesions of colorectal cancers, are not consistent.


METHODS
This cross-sectional study investigated the association of colorectal adenoma with H. pylori infection in a consecutive series of 2,195 asymptomatic average-risk subjects who underwent screening colonoscopy and H. pylori testing. Multivariate analyses were adjusted for potential relevant confounders, including age, sex, smoking, alcohol consumption, family history of colorectal cancer, and regular use of aspirin. Furthermore, we performed a systematic literature review and meta-analysis of available studies, including the current study, to clarify whether H. pylori infection is associated with an increased risk of colorectal adenoma.


RESULTS
Among 2,195 eligible subjects, 1,253 subjects were H. pylori seropositive and 942 subjects were seronegative. In the H. pylori (+) group, the prevalence of colorectal adenoma and advanced adenoma was significantly higher than in the H. pylori (-) group (25.3 vs. 20.1 %, p = 0.004 and 6.1 vs. 2.9 %, p < 0.001, respectively). In our multivariate analysis, H. pylori seropositivity was an independent risk factor for overall colorectal adenoma (OR = 1.36, 95 % CI = 1.10-1.68) and advanced adenoma (OR = 2.21, 95 % CI = 1.41-3.48). The positive association was confined in cases with any proximal adenoma. In the meta-analysis, which included ten studies and 15,863 patients, the pooled OR for colorectal adenoma related to H. pylori infection was 1.58 (95 % CI = 1.32-1.88).


CONCLUSIONS
Our results from this cross-sectional study and current studies included in our meta-analysis indicated that H. pylori infection was associated with a modest increase in the risk for colorectal adenoma.
Department of Internal Medicine, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729, Republic of Korea.
Sung Noh
SN
Hong
Seung Min
SM
Lee
Jeong Han
JH
Kim
Tae Yoon
TY
Lee
Jeong Hwan
JH
Kim
Won Hyeok
WH
Choe
Sun-Young
SY
Lee
Young Koog
YK
Cheon
In Kyung
IK
Sung
Hyung Seok
HS
Park
Chan Sup
CS
Shim
D000236:Adenoma / Q000453:epidemiology / Q000382:microbiology*; D000328:Adult; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000382:microbiology*; D003430:Cross-Sectional Studies; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D056910:Republic of Korea / Q000453:epidemiology; D012698:Serologic Tests