Gastric cancer in children infected with Helicobacter pylori.

BACKGROUND

This retrospective study aimed to define associations between Helicobacter pylori (H. pylori) in childhood and risk factors for gastric cancer with special emphasis on the role of family history of cancer.

AIM: To define associations between H. pylori in childhood and risk factors for gastric cancer with special emphasis on the role of family history of cancer.

METHODS

Details of 600 children who were subjected to upper gastrointestinal endoscopies at our institution are analyzed. Children were classified into positive and negative groups for H. pylori infection based on biopsy and rapid urease tests. The occurrences of gastric carcinoma, chronic superficial gastritis, glandular atrophy, and intestinal metaplasia among the groups are compared.

RESULTS

In our study, among the overall population, 330 children tested positive for H. pylori, which constituted 55% of the study population. The group denoting H. pylori positivity was found to have strikingly higher frequencies of chronic superficial gastritis (78.8% vs 5.9%), gastric atrophy (39.4% vs 7%), and intestinal metaplasia (0.9% vs 0%), as compared to the H. pylori-negative group. It is interesting to observe that there were a few but statistically significant cases of H. pylori-positive children having a family history of gastric cancer (1.2%), whereas no such cases were reported in children who were H. pylori-negative.

CONCLUSION

Our study finds that H. pylori infection in childhood is associated with an increased risk of precancerous gastric conditions and that family history might provide an additional risk. These insights recommend the necessity of early H. pylori detection and intervention and management strategies in childhood, especially in those families with histories of gastric cancer.