Mo1143 Sporadic Non-Ampullary Duodenal Adenoma/Carcinoma Is Associated With Not Only Colon Adenoma/Carcinoma but Also Gastric Cancer

Abstract

who had prior testing for H. pylori by serology or urease test of gastric tissue and subsequently underwent colonoscopy were analyzed. Presence of adenomas on colonoscopy findings was the outcome of interest with age, sex, race, H. pylori infection, triple therapy, and chronic PPI use as the independent variables. Chronic PPI use was defined as any PPI use for at least six months prior to colonoscopy. Multivariate regression analysis was used to calculate odds ratios at 95% confidence intervals. This study has been approved by the New York Medical College Institutional Review Board. Results: Fifty two percent (n=490) of the patients were H. pylori-positive and of these, 57.6% (n=282) had received treatment. Sixty-seven percent (n =630) of the sample had chronic PPI use. Thirty-five percent (n=325) of the patients are polyp positive and majority of the polyps were tubular adenomas (n =179, 55%). H. pylori infection was associated with increased odds of adenomas (adjusted OR 1.43, 95% CI 1.04-1.77) in the entire cohort. But this association grew stronger among patients older than 50 years (OR 1.65, 95% CI 1.18-2.33), suggesting an age-dependent effect of H. pylori on colonic adenomas. In the H. pylori group, triple therapy (OR 0.69, 95% CI 0.44-1.07) or chronic PPI use (OR 0.69, 95% CI 0.43-1.09) decreased the odds of adenomas. A post hoc analysis showed a statistically significant reduction in the odds of adenomas in patients who received both triple therapy and chronic PPI, further lowering the odds by 60% (adjusted OR 0.43, 95% CI 0.27-0.67). Conclusion: Our data suggest that there is an increased risk of adenomatous polyp among H. pylori-infected patients; however, triple therapy or chronic PPI use may mitigate the risk in this population, with further reduction of the risk when these two interventions are combined.