Helicobacter pylori eradication treatment and the risk of Barrett's esophagus and esophageal adenocarcinoma

Doorakkers, Eva; Lagergren, Jesper; Santoni, Giola; Engstrand, Lars; Brusselaers, Nele

doi:10.1111/HEL.12688

Title

Helicobacter pylori eradication treatment and the risk of Barrett's esophagus and esophageal adenocarcinoma

Author

Doorakkers, Eva

Lagergren, Jesper

Santoni, Giola

Engstrand, Lars

Brusselaers, Nele

Abstract

Background Helicobacter pylori (H. pylori) is associated with lower risks of Barrett's esophagus and esophageal adenocarcinoma, but whether H. pylori eradication increases the risk of these conditions is unknown. This study aimed to test the hypothesis that H. pylori eradication leads to gradually increased risks of Barrett's esophagus and esophageal adenocarcinoma over time, while esophageal squamous cell carcinoma was assessed for comparison reasons. Material and Methods This Swedish nationwide, population-based cohort study in 2005-2012 used data from the Swedish Prescribed Drug Registry to assess eradication treatment for H. pylori. Barrett's esophagus was identified from the Swedish Patient Registry, and esophageal adenocarcinoma and squamous cell carcinoma from the Swedish Cancer Registry. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were calculated by dividing the observed risk in the H. pylori eradication treatment cohort by the expected risk derived from the Swedish population of the same age, sex, and calendar period. Results The cohort included 81 919 patients having had eradication treatment. For Barrett's esophagus (n = 178), the overall SIR was increased (SIR 3.67, 95% CI 3.15-4.25), but the SIRs slightly decreased over time after eradication treatment. For esophageal adenocarcinoma (n = 11), the overall SIR was 1.26 (95% CI 0.62-2.26), and the SIRs did not increase over time. The SIRs of esophageal squamous cell carcinoma (n = 10) were not influenced by eradication treatment. Conclusions This study did not provide any evidence of an increasing risk of Barrett's esophagus or esophageal adenocarcinoma (or esophageal squamous cell carcinoma) over time after eradication treatment for H. pylori.

Language

English

Source (journal)

Helicobacter. - Cambridge, Mass.

Publication

Cambridge, Mass. : 2020

ISSN

1083-4389

DOI

10.1111/HEL.12688

Volume/pages

25 :3 (2020) , 6 p.