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Helicobacter pylori eradication treatment and the risk of Barrett's esophagus and esophageal adenocarcinoma
Author(s) -
Doorakkers Eva,
Lagergren Jesper,
Santoni Giola,
Engstrand Lars,
Brusselaers Nele
Publication year - 2020
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.12688
Subject(s) - medicine , barrett's esophagus , esophagus , gastroenterology , adenocarcinoma , helicobacter pylori , population , incidence (geometry) , cohort , cancer registry , esophageal cancer , cancer , physics , environmental health , optics
Background Helicobacter pylori ( H. pylori ) is associated with lower risks of Barrett's esophagus and esophageal adenocarcinoma, but whether H. pylori eradication increases the risk of these conditions is unknown. This study aimed to test the hypothesis that H. pylori eradication leads to gradually increased risks of Barrett's esophagus and esophageal adenocarcinoma over time, while esophageal squamous cell carcinoma was assessed for comparison reasons. Material and Methods This Swedish nationwide, population‐based cohort study in 2005‐2012 used data from the Swedish Prescribed Drug Registry to assess eradication treatment for H. pylori . Barrett's esophagus was identified from the Swedish Patient Registry, and esophageal adenocarcinoma and squamous cell carcinoma from the Swedish Cancer Registry. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were calculated by dividing the observed risk in the H. pylori eradication treatment cohort by the expected risk derived from the Swedish population of the same age, sex, and calendar period. Results The cohort included 81 919 patients having had eradication treatment. For Barrett's esophagus (n = 178), the overall SIR was increased (SIR 3.67, 95% CI 3.15‐4.25), but the SIRs slightly decreased over time after eradication treatment. For esophageal adenocarcinoma (n = 11), the overall SIR was 1.26 (95% CI 0.62‐2.26), and the SIRs did not increase over time. The SIRs of esophageal squamous cell carcinoma (n = 10) were not influenced by eradication treatment. Conclusions This study did not provide any evidence of an increasing risk of Barrett's esophagus or esophageal adenocarcinoma (or esophageal squamous cell carcinoma) over time after eradication treatment for H. pylori .