Helicobacter pylori Eradication Therapy and the Risk of Colorectal Cancer: A Population-Based Nationwide Cohort Study in Sweden

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Helicobacter Pub Date : 2024-11-20 DOI:10.1111/hel.70001

Qing Liu, Omid Sadr-Azodi, Lars Engstrand, Katja Fall, Nele Brusselaers

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Abstract

Background

Helicobacter pylori (H. pylori) is an established gastric carcinogen, also associated with an increased risk of colorectal cancer. Therefore, we suspected that H. pylori eradication lowers the risk of colorectal cancer.

Material and Methods

We assessed if H. pylori eradication therapy is associated with a reduced risk of colorectal adenocarcinoma in a population-based nationwide cohort study. This study included all Swedish adults with at least one recorded H. pylori eradication episode between July 2005 and December 2012, based on the high-quality Swedish health registries. Colorectal adenocarcinoma risks were compared to the Swedish background population, presented as standardized incidence ratios (SIRs) and 95% confidence intervals (CIs), accounting for age, sex, calendar period, tumor location (left or right sided), stage, and number of eradication episodes, from 1 year after eradication and onward.

Results

Among 80,381 individuals receiving H. pylori eradication therapy (average follow-up 4.1 years), 282 were diagnosed with colorectal cancer (97.2% adenocarcinoma). Overall, H. pylori eradication was associated with an elevated risk of colorectal adenocarcinoma (SIR 1.27, 95% CI: 1.12–1.43). The colorectal adenocarcinoma risk was increased 1–2 years after eradication (SIR 1.42, 95% CI: 1.17–1.72), then decreased 2–4 years (SIR 0.80, 95% CI: 0.65–0.98) and 4–6 years (SIR 0.76, 95% CI: 0.57–0.99), yet not ≥ 6 years (SIR 1.36, 95% CI: 0.78–2.21) after eradication compared to the general population. Overall, right-sided (SIR 1.47, 95% CI: 1.21–1.76) and left-sided (SIR 1.35, 95% CI: 1.09–1.67) colon adenocarcinomas risks were higher among eradicated individuals than the general population.

Conclusion

H. pylori eradication was not associated with a clear and consistent reduction of colorectal cancer in our Swedish cohort.

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幽门螺杆菌根除疗法与结直肠癌风险：瑞典基于人口的全国队列研究

背景幽门螺杆菌（H. pylori）是一种公认的胃癌致癌物，也与结直肠癌风险增加有关。因此，我们怀疑根除幽门螺杆菌可降低结直肠癌的风险。材料和方法我们在一项全国性人群队列研究中评估了根除幽门螺杆菌治疗是否与结直肠腺癌风险的降低有关。这项研究纳入了 2005 年 7 月至 2012 年 12 月期间至少有一次幽门螺杆菌根除病例记录的所有瑞典成年人，其依据是高质量的瑞典健康登记。在考虑年龄、性别、日历时间、肿瘤位置（左侧或右侧）、分期和根除次数的情况下，将根除后1年及以后的结直肠腺癌风险与瑞典背景人群进行比较，并以标准化发病率比（SIR）和95%置信区间（CI）表示。结果在接受幽门螺杆菌根除治疗的 80,381 人中（平均随访 4.1 年），有 282 人被确诊为结直肠癌（97.2% 为腺癌）。总体而言，根除幽门螺杆菌与结直肠腺癌风险升高有关（SIR 1.27，95% CI：1.12-1.43）。与普通人群相比，根除幽门螺杆菌后 1-2 年的结直肠腺癌风险增加（SIR 1.42，95% CI：1.17-1.72），2-4 年（SIR 0.80，95% CI：0.65-0.98）和 4-6 年（SIR 0.76，95% CI：0.57-0.99）的风险降低，但根除后≥ 6 年的风险没有增加（SIR 1.36，95% CI：0.78-2.21）。总体而言，根除者患右侧（SIR 1.47，95% CI：1.21-1.76）和左侧（SIR 1.35，95% CI：1.09-1.67）结肠腺癌的风险高于普通人群。结论在我们的瑞典队列中，根除幽门螺杆菌与结直肠癌发病率的明显持续下降无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.