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Gastric Helicobacter pylori infection associates with an increased risk of colorectal polyps in African Americans.
BMC Cancer. 2014 Apr 28; 14:296.BC

Abstract

BACKGROUND

Gastric Helicobacter pylori (H. pylori) infection and colorectal polyps are more prevalent in African Americans than in the general population. We aimed to investigate whether gastric H. pylori infection is associated with colorectal polyps in African Americans.

METHODS

Medical records of African Americans, 40 years and older (n = 1256) who underwent bidirectional gastrointestinal endoscopy on the same day were reviewed. H. pylori status was assessed by immunohistochemistry on gastric specimens. Colorectal polyps were confirmed by histological examination of colorectal biopsies. A subset of serum samples from healthy and polyp-bearing patients (n = 163) were analyzed by ELISA for anti-H. pylori and anti-CagA antibodies. The crude and adjusted effect of H. pylori on the risk of colorectal adenoma and polyp were computed by logistic regression models.

RESULTS

The prevalence of colorectal polyps and adenomas were 456 (36%) and 300 (24%) respectively. Colorectal polyps were more prevalent in gastric H. pylori infected than non-infected subjects [43% vs. 34%; Odds Ratio (OR) (95% CI): 1.5 (1.2-1.9), P = 0.001]. Patients with H. pylori-associated chronic active gastritis were at high risk to have adenomas [Unadjusted OR (95% CI): 1.3 (1.0-1.8); P = 0.04]. There was no difference in histopathology, size, or location of polyps with respect to H. pylori status. Gastric H. pylori infection, age, male gender and high risk clinical presentations were independent risk factors for colorectal polyps. Serological testing also revealed a higher prevalence of H. pylori and its toxin Cag-A in polyp patients vs. non polyp patients' sera, although in a non-statistically significant manner.

CONCLUSIONS

This study showed that current gastric H. pylori infection is associated with an increased risk of colorectal polyps in African Americans. Patients with H. pylori induced gastritis may benefit from early screening colonoscopy as a preventative measure for colorectal cancer.

Authors+Show Affiliations

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableDepartment of Medicine and Cancer Center, Howard University, Washington, DC, USA. hashktorab@howard.edu.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24774100

Citation

Brim, Hassan, et al. "Gastric Helicobacter Pylori Infection Associates With an Increased Risk of Colorectal Polyps in African Americans." BMC Cancer, vol. 14, 2014, p. 296.
Brim H, Zahaf M, Laiyemo AO, et al. Gastric Helicobacter pylori infection associates with an increased risk of colorectal polyps in African Americans. BMC Cancer. 2014;14:296.
Brim, H., Zahaf, M., Laiyemo, A. O., Nouraie, M., Pérez-Pérez, G. I., Smoot, D. T., Lee, E., Razjouyan, H., & Ashktorab, H. (2014). Gastric Helicobacter pylori infection associates with an increased risk of colorectal polyps in African Americans. BMC Cancer, 14, 296. https://doi.org/10.1186/1471-2407-14-296
Brim H, et al. Gastric Helicobacter Pylori Infection Associates With an Increased Risk of Colorectal Polyps in African Americans. BMC Cancer. 2014 Apr 28;14:296. PubMed PMID: 24774100.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gastric Helicobacter pylori infection associates with an increased risk of colorectal polyps in African Americans. AU - Brim,Hassan, AU - Zahaf,Marwah, AU - Laiyemo,Adeyinka O, AU - Nouraie,Mehdi, AU - Pérez-Pérez,Guillermo I, AU - Smoot,Duane T, AU - Lee,Edward, AU - Razjouyan,Hadie, AU - Ashktorab,Hassan, Y1 - 2014/04/28/ PY - 2013/08/19/received PY - 2014/03/04/accepted PY - 2014/4/30/entrez PY - 2014/4/30/pubmed PY - 2015/2/20/medline SP - 296 EP - 296 JF - BMC cancer JO - BMC Cancer VL - 14 N2 - BACKGROUND: Gastric Helicobacter pylori (H. pylori) infection and colorectal polyps are more prevalent in African Americans than in the general population. We aimed to investigate whether gastric H. pylori infection is associated with colorectal polyps in African Americans. METHODS: Medical records of African Americans, 40 years and older (n = 1256) who underwent bidirectional gastrointestinal endoscopy on the same day were reviewed. H. pylori status was assessed by immunohistochemistry on gastric specimens. Colorectal polyps were confirmed by histological examination of colorectal biopsies. A subset of serum samples from healthy and polyp-bearing patients (n = 163) were analyzed by ELISA for anti-H. pylori and anti-CagA antibodies. The crude and adjusted effect of H. pylori on the risk of colorectal adenoma and polyp were computed by logistic regression models. RESULTS: The prevalence of colorectal polyps and adenomas were 456 (36%) and 300 (24%) respectively. Colorectal polyps were more prevalent in gastric H. pylori infected than non-infected subjects [43% vs. 34%; Odds Ratio (OR) (95% CI): 1.5 (1.2-1.9), P = 0.001]. Patients with H. pylori-associated chronic active gastritis were at high risk to have adenomas [Unadjusted OR (95% CI): 1.3 (1.0-1.8); P = 0.04]. There was no difference in histopathology, size, or location of polyps with respect to H. pylori status. Gastric H. pylori infection, age, male gender and high risk clinical presentations were independent risk factors for colorectal polyps. Serological testing also revealed a higher prevalence of H. pylori and its toxin Cag-A in polyp patients vs. non polyp patients' sera, although in a non-statistically significant manner. CONCLUSIONS: This study showed that current gastric H. pylori infection is associated with an increased risk of colorectal polyps in African Americans. Patients with H. pylori induced gastritis may benefit from early screening colonoscopy as a preventative measure for colorectal cancer. SN - 1471-2407 UR - https://www.unboundmedicine.com/medline/citation/24774100/Gastric_Helicobacter_pylori_infection_associates_with_an_increased_risk_of_colorectal_polyps_in_African_Americans_ L2 - https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-14-296 DB - PRIME DP - Unbound Medicine ER -