Premium
The association between Helicobacter pylori infection and the risk of advanced colorectal neoplasia may differ according to age and cigarette smoking
Author(s) -
Park Hyunsung,
Park Jae Jun,
Park Yoo Mi,
Baik Su Jung,
Lee Hyun Ju,
Jung Da Hyun,
Kim JieHyun,
Youn Young Hoon,
Park Hyojin
Publication year - 2018
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12477
Subject(s) - medicine , helicobacter pylori , odds ratio , gastroenterology , rapid urease test , colonoscopy , helicobacter pylori infection , confidence interval , colorectal cancer , family history , epidemiology , cancer
Background The association between Helicobacter pylori infection and advanced colorectal neoplasia ( ACN ) remains controversial. This study aimed to clarify the association between H. pylori infection and ACN according to age groups. Methods We retrospectively analyzed the association between H. pylori infection and ACN in patients aged <50 and ≥50 years receiving a health checkup that included colonoscopy. Helicobacter pylori positivity was determined by the results of serum anti‐ H. pylori immunoglobulin G or rapid urease test, if the anti‐ H. pylori immunoglobulin G was in the borderline range. Results Among the 19 337 patients who were included, 56.2% and 3.4% were positive for H. pylori and ACN , respectively. Helicobacter pylori infection independently increased the risk of ACN in patients aged <50 years (odds ratio [ OR ], 1.602; 95% confidence intervals [ CI ], 1.194‐2.150) but not in patients aged ≥50 years ( OR , 1.046; 95% CI , 0.863‐1.268). The positive association between H. pylori infection and ACN was affected by smoking history. When stratified by age and smoking history, H. pylori infection conferred an increased risk of ACN in patients aged <50 years with a history of smoking ( OR , 1.926; 95% CI , 1.336‐2.775) but not in the other 3 groups (3‐way interaction test P = .023). Among patients aged <50 years with ACN , ACN in the left colon was found more frequently in patients with H. pylori infection and a history of smoking than in those without (69.3% vs 54.4%, respectively; P = .031). Conclusions Helicobacter pylori infection confers an increased risk of ACN , but the association may differ according to age and smoking history.