title: Helicobacter pylori is a risk factor for colonic neoplasms.
abstract: OBJECTIVE
  It has been suggested that Helicobacter pylori (H. pylori) constitutes a risk for the development of adenomatous polyps and adenocarcinoma of the colon. Our aim was to study the association between H. pylori-positive gastritis and the occurrence of any colonic neoplasm.
  
  
  METHODS
  From a computerized database of surgical pathology reports, we selected 156,000 subjects who underwent colonoscopy and esophago-gastro-duodenoscopy with biopsy results from both procedures.
  
  
  RESULTS
  Compared with normal gastric mucosa, H. pylori gastritis occurred more frequently among patients with hyperplastic polyps (OR=1.24, 95% CI: 1.18-1.30), adenomatous polyps (1.52, 1.46-1.57), advanced adenomas (1.80, 1.69-1.92), villous adenomas or adenomas with high-grade dysplasia (1.97, 1.82-2.14), and adenocarcinomas (2.35, 1.98-2.80). Similarly, the strength of the association between H. pylori-positive gastritis and colonic neoplasm increased with size and number of the adenomas. The association between H. pylori gastritis and the occurrence of colonic neoplasm was similar for different locations of the large bowel. Other gastric conditions etiologically associated with H. pylori, such as intestinal metaplasia, adenoma, lymphoma, and adenocarcinoma, were also significantly associated with an increased risk of colonic neoplasm.
  
  
  CONCLUSIONS
  Various forms of gastritis related to H. pylori infection confer an increased risk for colonic neoplasm. In the past, when H. pylori infection was more prevalent, its attributable risk to the occurrence of colorectal neoplasm may have been quite substantial.
authors.affiliation: Gastroenterology, Portland VA Medical Center P3-GI, 3710 SW US Veterans Hospital Road, Portland, Oregon 97239, USA. sonnenbe@ohsu.edu
authors.forename: Amnon
authors.initials: A
authors.lastname: Sonnenberg
authors.forename: Robert M
authors.initials: RM
authors.lastname: Genta
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000382:microbiology* / Q000473:pathology / Q000517:prevention & control; D000236:Adenoma / Q000150:complications / Q000382:microbiology; D011125:Adenomatous Polyposis Coli / Q000382:microbiology* / Q000473:pathology / Q000517:prevention & control; D000328:Adult; D000368:Aged; D003110:Colonic Neoplasms / Q000382:microbiology* / Q000473:pathology / Q000517:prevention & control; D016208:Databases, Factual; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D005756:Gastritis / Q000150:complications* / Q000382:microbiology*; D016481:Helicobacter Infections / Q000150:complications* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D008223:Lymphoma / Q000150:complications / Q000382:microbiology; D008297:Male; D008679:Metaplasia / Q000382:microbiology; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D011634:Public Health / Q000639:trends; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000150:complications*