ACG: H. pylori Infection Linked to Higher Rate of Colonic Adenomas

October 15, 2007

PHILADELPHIA -- Helicobacter pylori infection has been associated with the development of adenomatous polyps of the colon, according to a study reported here.

PHILADELPHIA, Oct. 15 -- Helicobacter pylori infection has been associated with the development of adenomatous polyps of the colon, according to a study reported here.

H. pylori-positive patients had 2.5 times as many adenomas on colonoscopy as did patients negative for the infection, Trinh Meyer, M.D., of Beth Israel Medical Center in New York said at the American College of Gastroenterology meeting. The polyps were significantly more common in men than in women.

"The findings suggest that patients who are H. pylori positive, particularly men, might need to be screened more frequently for colorectal cancer than is currently recommended," said Dr. Meyer.

Several studies have examined the association between H. pylori infection and colorectal cancer, and the results have been mixed. A recent meta-analysis found a small but statistically significant association (Helicobacter 2006;11:75-80). However, the authors acknowledged the potential for publication bias and called for continued investigation of the issue.

Dr. Meyer and colleagues retrospectively reviewed gastric biopsy results over a four-year period and pathology data on colorectal lesions identified by colonoscopy within six years of testing for H. pylori infection. They identified 410 patients, and 173 (42%) of them were H. pylori positive. The only significant difference between patients with and without infection was the predominance of H. pylori-positive men (54.9% versus 41.7%, P=0.009).

Among H. pylori-negative patients, 60% had normal colonoscopic findings, 20% had tubular adenomas, and none had adenocarcinoma. In contrast, 29% of the H. pylori-positive patients had normal colonoscopies (P<0.0001), 50% had tubular adenomas (P<0.0001), and one patient (0.6%) had adenocarcinoma.

Additionally, 63 of 95 (59%) H. pylori-positive men had tubular adenomas compared with 44 of 78 (41%) women (P=0.008).

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