Abstract
BackgroundHelicobacter pylori(H. pylori) is a gram-negative gastrointestinal pathogen that colonises the human stomach and is considered a major risk factor for gastric cancer and mucosa-associated lymphoid tissue lymphoma. Furthermore,H. pyloriis a potential trigger of a wide spectrum of extragastric cancer entities, extraintestinal chronic inflammatory processes and autoimmune diseases. In the present study, we evaluated the association betweenH. pyloriinfection and its eradication with the development of subsequent gastrointestinal and non-gastrointestinal cancer.MethodsWe identified 25 317 individuals with and 25 317 matched individuals without a diagnosis ofH. pylorifrom the Disease Analyzer database (IQVIA). A subsequent cancer diagnosis was analysed using Kaplan-Meier and conditional Cox-regression analysis as a function ofH. pyloriand its eradication.ResultsAfter 10 years of follow-up, 12.8% of theH. pyloricohort and 11.8% of the non-H. pyloricohort were diagnosed with cancer (p=0.002). Results were confirmed in regression analysis (HR: 1.11; 95% CI 1.04 to 1.18). Moreover, a non-eradicatedH. pyloristatus (HR: 1.18; 95% CI 1.07 to 1.30) but not an eradicatedH. pyloristatus (HR: 1.06; 95% CI 0.97 to 1.15) was associated with a subsequent diagnosis of cancer. In subgroup analyses,H. pylorieradication was negatively associated with bronchus and lung cancer (HR: 0.60; 95% CI 0.44 to 0.83).ConclusionOur data from a large outpatient cohort in Germany reveal a distinct association betweenH. pyloriinfection and the subsequent development of cancer. These data might help to identify patients at risk and support eradication strategies in the future.