title: Equivalent Helicobacter pylori infection rates in Lynch syndrome mutation carriers with and without a first-degree relative with gastric cancer.
abstract: BACKGROUND
  Patients with Lynch syndrome (LS) are at an increased risk of developing gastric cancer. In 2010, a guideline that recommended to screen all patients for Helicobacter pylori was implemented in the Netherlands. H. pylori is an important risk factor in the development of gastric cancer in the general population, and eradication of the bacterium reduces this risk. We aimed to assess the proportion of LS patients being tested and the yield and also addressed the question whether H. pylori infection is more prevalent in LS families with known cases of gastric cancer.
  
  
  METHODS
  Proven mutation carriers from five different Dutch hospitals were included. The implementation of H. pylori screening and its outcome was examined. The observation period was 2008-2013. The presence of first-degree family members with gastric cancer was noted, and it was observed if H. pylori infection was more prevalent in Lynch families with known cases of gastric cancer. Obtainable endoscopy reports were reviewed.
  
  
  RESULTS
  Four hundred forty-three (male, 184) proven mutation carriers were included. The proportion of patients screened increased after 2010, from 37 to 68%. Twenty percent of the patients were infected. The 25 patients who had a first-degree family member with gastric cancer did not have a higher infection rate. In 30% of cases, an endoscopy was performed; in four patients, intestinal metaplasia and in eight patients, gastric cancer was found.
  
  
  CONCLUSIONS
  The recommendation to screen for H. pylori is increasingly followed. The prevalence of infection in this patient group does not differ from the general population. Patients who had a first-degree family member with gastric cancer did not have a higher infection rate.
authors: Department of Gastroenterology and Hepatology, Isala Clinics, Zwolle, The Netherlands. e.c.soer@amc.uva.nl.
authors: Eline C
authors: EC
authors: Soer
authors: Department of Gastroenterology and Hepatology, Isala Clinics, Zwolle, The Netherlands.
authors: Laura W
authors: LW
authors: Leicher
authors: Department of Gastroenterology and Hepatology, Leiden University Medical Center, Isala Clinics, P.O. box 10400, 8000 GK, Zwolle, The Netherlands.
authors: Alexandra M J
authors: AM
authors: Langers
authors: Department of Gastroenterology and Hepatology, Slingeland Ziekenhuis, Doetinchem, The Netherlands.
authors: Paul C
authors: PC
authors: van de Meeberg
authors: Department of Gastroenterology and Hepatology, Isala Clinics, Zwolle, The Netherlands.
authors: Egbert-Jan
authors: EJ
authors: van der Wouden
authors: Department of Gastroenterology and Hepatology, Groningen University Medical Center, Groningen, The Netherlands.
authors: Jan Jakob
authors: JJ
authors: Koornstra
authors: Department of Gastroenterology and Hepatology, Medisch Spectrum Twente, Enschede, The Netherlands.
authors: Marloes
authors: M
authors: Bigirwamungu-Bargeman
authors: The Netherlands Foundation for the Detection of Hereditary Tumors, Leiden, The Netherlands.
authors: Hans F A
authors: HF
authors: Vasen
authors: Department of Gastroenterology and Hepatology, Isala Clinics, Zwolle, The Netherlands.
authors: Wouter H
authors: WH
authors: de Vos tot Nederveen Cappel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000235:genetics* / Q000382:microbiology*; D004724:Endoscopy; D005190:Family; D005260:Female; D016481:Helicobacter Infections / Q000382:microbiology*; D016480:Helicobacter pylori / Q000502:physiology*; D006579:Heterozygote; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D013274:Stomach Neoplasms / Q000235:genetics*; D055815:Young Adult
keywords: Gastric cancer; Helicobacter pylori; Lynch syndrome