Helicobacter pylori eradication treatment and the risk of Barrett's esophagus and esophageal adenocarcinoma.
Adenocarcinoma
/ etiology
Anti-Bacterial Agents
/ therapeutic use
Barrett Esophagus
/ etiology
Cohort Studies
Disease Eradication
Esophageal Neoplasms
/ etiology
Esophageal Squamous Cell Carcinoma
Female
Helicobacter Infections
/ drug therapy
Helicobacter pylori
/ drug effects
Humans
Incidence
Male
Middle Aged
Proton Pump Inhibitors
/ therapeutic use
Risk Factors
Helicobacter pylori
Barrett' s esophagus
Neoplasm
antibiotics
esophageal
proton-pump inhibitors
Journal
Helicobacter
ISSN: 1523-5378
Titre abrégé: Helicobacter
Pays: England
ID NLM: 9605411
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
31
01
2020
revised:
18
02
2020
accepted:
20
02
2020
pubmed:
17
3
2020
medline:
4
11
2020
entrez:
17
3
2020
Statut:
ppublish
Résumé
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. 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. 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. 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.
Sections du résumé
BACKGROUND
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
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
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
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.
Substances chimiques
Anti-Bacterial Agents
0
Proton Pump Inhibitors
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e12688Subventions
Organisme : Svenska Läkaresällskapet
ID : SLS-503461
Organisme : Svenska Läkaresällskapet
ID : SLS-688231
Organisme : Svenska Läkaresällskapet
ID : SLS-688151
Organisme : Karolinska Institutet
Organisme : Strategic Research Area Epidemiology (SFO)
Informations de copyright
© 2020 The Authors. Helicobacter published by John Wiley & Sons Ltd.
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