Linda S Kornerup1, Peter Jepsen1,2, Lars E Bartels3, Jens F Dahlerup1, Hendrik Vilstrup1. 1. Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark. 2. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. 3. Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.
Abstract
Background and aims: Helicobacter pylori (HP) is known to be involved in intestinal carcinogenesis. As regards hepatobiliary cancers, there are few and inconsistent reports. We investigated HP infection and its association with the incidence of hepatobiliary cancers in a large cohort study. The cohort's appropriateness for the purpose was gauged by its ability to identify the established risk relation to gastric cancer. Methods: This historical study was performed in the Central Denmark Region. Patients were included from primary healthcare after being tested for HP infection with a urea breath test. Patients' diagnoses, age, gender, and country of birth were obtained from Danish national administrative registries. Cox regression was used to compare incidences of hepatobiliary and gastric cancer between HP-positive and HP-negative persons, adjusting for confounding variables. Results: A total of 53,633 persons were included and 10,553 were tested HP-positive. They were followed for a median of 4.6 years (total 250,515 person-years). We found 64 hepatobiliary cancers, with a markedly lower incidence in HP-positive persons; HR = 0.27 (95% CI 0.11-0.68). A higher incidence of gastric cancer in HP-positive persons was confirmed (HR = 1.99 (95% CI 1.35-2.94)). Conclusion: The incidence of hepatobiliary cancers was remarkably lower in HP-infected persons after adjusting for age, gender, cirrhosis, alcohol-related diagnoses, chronic viral hepatitis, and country of origin. We found no methodological cause for this unexpected finding, and the pathogenic links between the infection and cancer remain to be identified. Our results must be confirmed in a similar cohort.
Background and aims: Helicobacter pylori (HP) is known to be involved in intestinal carcinogenesis. As regards hepatobiliary cancers, there are few and inconsistent reports. We investigated HP infection and its association with the incidence of hepatobiliary cancers in a large cohort study. The cohort's appropriateness for the purpose was gauged by its ability to identify the established risk relation to gastric cancer. Methods: This historical study was performed in the Central Denmark Region. Patients were included from primary healthcare after being tested for HP infection with a urea breath test. Patients' diagnoses, age, gender, and country of birth were obtained from Danish national administrative registries. Cox regression was used to compare incidences of hepatobiliary and gastric cancer between HP-positive and HP-negative persons, adjusting for confounding variables. Results: A total of 53,633 persons were included and 10,553 were tested HP-positive. They were followed for a median of 4.6 years (total 250,515 person-years). We found 64 hepatobiliary cancers, with a markedly lower incidence in HP-positive persons; HR = 0.27 (95% CI 0.11-0.68). A higher incidence of gastric cancer in HP-positive persons was confirmed (HR = 1.99 (95% CI 1.35-2.94)). Conclusion: The incidence of hepatobiliary cancers was remarkably lower in HP-infected persons after adjusting for age, gender, cirrhosis, alcohol-related diagnoses, chronic viral hepatitis, and country of origin. We found no methodological cause for this unexpected finding, and the pathogenic links between the infection and cancer remain to be identified. Our results must be confirmed in a similar cohort.
Authors: P Malfertheiner; F Megraud; C A O'Morain; J P Gisbert; E J Kuipers; A T Axon; F Bazzoli; A Gasbarrini; J Atherton; D Y Graham; R Hunt; P Moayyedi; T Rokkas; M Rugge; M Selgrad; S Suerbaum; K Sugano; E M El-Omar Journal: Gut Date: 2016-10-05 Impact factor: 23.059
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Authors: Tomi Akinyemiju; Semaw Abera; Muktar Ahmed; Noore Alam; Mulubirhan Assefa Alemayohu; Christine Allen; Rajaa Al-Raddadi; Nelson Alvis-Guzman; Yaw Amoako; Al Artaman; Tadesse Awoke Ayele; Aleksandra Barac; Isabela Bensenor; Adugnaw Berhane; Zulfiqar Bhutta; Jacqueline Castillo-Rivas; Abdulaal Chitheer; Jee-Young Choi; Benjamin Cowie; Lalit Dandona; Rakhi Dandona; Subhojit Dey; Daniel Dicker; Huyen Phuc; Donatus U. Ekwueme; Maysaa El Sayed Zaki; Florian Fischer; Thomas Fürst; Jamie Hancock; Simon I. Hay; Peter Hotez; Sun Ha Jee; Amir Kasaeian; Yousef Khader; Young-Ho Khang; Anil Kumar; Michael Kutz; Heidi Larson; Alan Lopez; Raimundas Lunevicius; Reza Malekzadeh; Colm McAlinden; Toni Meier; Walter Mendoza; Ali Mokdad; Maziar Moradi-Lakeh; Gabriele Nagel; Quyen Nguyen; Grant Nguyen; Felix Ogbo; George Patton; David M. Pereira; Farshad Pourmalek; Mostafa Qorbani; Amir Radfar; Gholamreza Roshandel; Joshua A Salomon; Juan Sanabria; Benn Sartorius; Maheswar Satpathy; Monika Sawhney; Sadaf Sepanlou; Katya Shackelford; Hirbo Shore; Jiandong Sun; Desalegn Tadese Mengistu; Roman Topór-Mądry; Bach Tran; Vasiliy Vlassov; Stein Emil Vollset; Theo Vos; Tolassa Wakayo; Elisabete Weiderpass; Andrea Werdecker; Naohiro Yonemoto; Mustafa Younis; Chuanhua Yu; Zoubida Zaidi; Liguo Zhu; Christopher J. L. Murray; Mohsen Naghavi; Christina Fitzmaurice Journal: JAMA Oncol Date: 2017-12-01 Impact factor: 31.777