Abstract
Helicobacter pylori infection may be associated with an increased risk of colorectal carcinoma. However, as most studies on this subject were relatively small in size and differed at least partially in their designs, their results remain controversial. In this study, we aimed to carry out a meta-analysis to evaluate the potential association of H. pylori infection with colorectal adenoma and adenocarcinoma risk, covering all of the different testing methods. We conducted a search in PubMed, Medline, EBSCO, High Wire Press, OVID, and EMBASE covering all published papers up to March 2013. According to the established inclusion criteria, essential data were then extracted from the included studies and further analyzed by a systematic meta-analysis. Odds ratios were employed to evaluate the relationship between H. pylori infection and the risk of colorectal neoplasms. Twenty-two studies were included, and the odds ratio for the association between H. pylori infection and colorectal cancer was 1.49 (95% confidence interval 1.30-1.72). No statistically significant heterogeneity was observed. Publication bias was ruled out. The pooled data suggest H. pylori infection indeed increases the risk of colorectal adenoma and adenocarcinoma.
Highlights
Colorectal cancer is a major cause of cancer-related morbidity and mortality; it is the 3rd most common malignancy and 4th most common cause of cancer mortality worldwide (Tenesa et al, 2009)
We conducted a manual search in PubMed, Medline, EBSCO, High Wire Press, OVID, EMBASE, and other databases, which resulted in 12 more studies that met the inclusion criteria.22 case-control studies were included in this study (Figure 1)
We evaluated the possible relationship between H. pylori infection and the risk of colorectal adenoma and adenocarcinoma by carrying out a quantitative meta-analysis
Summary
Colorectal cancer is a major cause of cancer-related morbidity and mortality; it is the 3rd most common malignancy and 4th most common cause of cancer mortality worldwide (Tenesa et al, 2009). Specific genetic and molecular alterations in colonic epithelial cells result in the inactivation of tumor suppressor genes, such as APC, DCC, DPC4, and p53, along with the activation of oncogenes (Fearon et al, 1990). These genetic mutations lead to the transformation of normal epithelium into dysplastic epithelium with increased proliferation, resulting in the development of adenomatous polyps, which have the malignant potential to progress to adenocarcinoma. We aimed to carry out a meta-analysis to evaluate the potential association of H. pylori infection with colorectal adenoma and adenocarcinoma risk, covering all of the different testing methods. Conclusion: The pooled data suggest H. pylori infection increases the risk of colorectal adenoma and adenocarcinoma
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