Preventive Effect of Helicobacter pylori Treatment on Colorectal Cancer Incidence and Mortality.

BACKGROUND AND AIM: Many studies have reported an association between Helicobacter pylori infection and an increased risk of colorectal cancer (CRC); however, the impact of eradication therapy on CRC remains unclear. We compared CRC incidence and mortality in individuals who received H. pylori treatment with those in the general population.

METHODS

We conducted a population-based study of 931 585 participants aged ≥ 20 years who received H. pylori eradication (HPE) therapy between 2009 and 2011. We used the one-sample log-rank test to compare standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) for CRC.

RESULTS

The mean follow-up period was 12.4 ± 1.1 years. CRC incidence and mortality rates were significantly lower in H. pylori-treated individuals than in the general population (total SIR: 0.66, 95% confidence intervals [CI] 0.64-0.67 and SMR: 0.51, 95% CI 0.49-0.54). Significant results were also observed in the 30-39, 40-49, 50-59, 60-69, and ≥ 70 age groups: The SIRs (95% CIs) were 0.80 (0.71-0.89), 0.73 (0.70-0.77), 0.62 (0.60-0.65), 0.66 (0.63-0.68), and 0.62 (0.59-0.66), respectively, and the SMRs (95% CIs) were 0.53 (0.36-0.76), 0.46 (0.39-0.54), 0.41 (0.37-0.46), 0.48 (0.44-0.53), and 0.65 (0.60-0.71), respectively. Similar results were observed when colon and rectal cancer were analyzed separately.

CONCLUSIONS

HPE may help reduce the risk and improve the survival from CRC. Its benefits may extend beyond preventing gastric cancer to CRC prevention. Our findings support the need for aggressive H. pylori screening and eradication treatment.