Hp-Positive Chinese Patients Should Undergo Colonoscopy Earlier and More Frequently: The Result of a Cross-Sectional Study Based on 13,037 Cases of Gastrointestinal Endoscopy

Abstract

BackgroundIn China, the prevalence and mortality of colorectal cancer (CRC) have always been high, and more than 95% of CRC cases have evolved from colorectal polyps (CPs), especially adenoma. Early detection and treatment of CPs through colonoscopy is essential to reduce the incidence of CRC. Helicobacter pylori (Hp) is regarded as a risk factor for gastritis and gastric cancer and may also be a risk factor for CPs and CRC. However, few studies based on vast clinical cases exist in China to clarify whether Hp is a risk factor for CPs and CRC, and whether Hp-positive patients need to undergo colonoscopy checks earlier. This article attempts to make up for that deficiency.MethodThis cross-sectional study was conducted based on 13,037 patients without a treatment history of Hp who underwent their first gastroscopy and colonoscopy simultaneously at The First Affiliated Hospital of Zhejiang Chinese Medical University from January 2018 to December 2019. Pearson χ2 test and logistic regression were used to determine whether Hp is a risk factor for CPs and CRC. Multifactor analysis of variance was used to define the impact of Hp on CPs prevalence with different ages, sexes.ResultsFor Chinese individuals, Hp is a risk factor for CPs and CRC. The odds ratio (OR) value are 1.228 (95% CI, 1.130 to 1.336) and 1.862 (95% CI 1.240-2.796), respectively. Hp-positive patients have a higher probability of multiple or large intestinal polyps. However, Hp infection does not increase the incidence of adenomas, nor does it affect the pathological type of adenomas. The OR of Hp on the risk of CPs was 1.432 (95%CI 1.275-1.608) for males but increased to 1.937 (95%CI 1.334-2.815) for those aged 35 to 40. For females, the results were similar.ConclusionsFor the Chinese, Hp is a risk factor for CPs and CRC (OR>1); the infection of Hp increased CPs risk in Chinese of all ages, especially aged 35-40, suggesting that Hp-positive patients should undergo colonoscopy frequently.

The relationship between colorectal cancer and gastric histopathology: case-control study

“…Strains of the enterotoxigenic Bacteroides fragilis (ETBF) bft gene have been shown to contribute to colon carcinogenesis. In the studies of Wang C, et al (25) and Lee JY, et al (34) it increased the risk of CRC when H. pylori infection and AG were positive together. In the Montani A. et al (31) study, although chronic H. pylori infection and atrophic gastritis might increase the risk of rectal cancer, they did not increase the risk of CRC.…”

MarkerGenie: an NLP-enabled text-mining system for biomedical entity relation extraction

“…The top 10 microbes with the highest occurrences are shown in B, among these, eight of them have been previously shown to be significantly associated with CRC in the meta-analysis study ( Thomas et al , 2019 ). The remaining two microbes ‘Helicobacter pylori’ and ‘Human papillomavirus’ also have been shown to be strongly related to CRC in more recent work ( Chao et al , 2020 ; Wang et al , 2021 ). These results should provide a good reference to researchers studying CRC and the microbiome.…”