The relationship of Helicobacter pylori infection and colon neoplasia, on the basis of meta-analysis

BACKGROUND: Helicobacter pylori is an important causative factor in gastric carcinogenesis. However, its role in extragastric gastrointestinal malignancies, such as colon neoplasia, is controversial. AIM: The aim of this study was to explore the relationship of H. pylori infection with colon neoplasia by meta-analysis of all relevant studies. MATERIALS AND METHODS: Pooled estimates were obtained using fixed or random-effects models as appropriate. Heterogeneity between studies was evaluated using the Cochran Q-test, whereas the likelihood of publication bias was assessed by constructing funnel plots. RESULTS: Among 238 potentially relevant studies, 210 were rejected as unsuitable and 28 studies were finally eligible for meta-analysis, including a total of 33 sets of data (17 on colon cancer and 16 on colon polyps). There was evidence of heterogeneity (I=57.37%); thus, the random-effects model of meta-analysis was chosen, showing pooled odds ratio (OR) equal to 1.41 [95% confidence interval 1.24-1.60, P=0.000]. The subgroup meta-analyses showed a significant relationship between H. pylori and colon cancer as well as colon polyps [OR 1.3 (1.07-1.59), P=0.01 and OR 1.5 (1.26-1.79), P=0.000, respectively]. CONCLUSION: The results of this meta-analysis showed a modest statistically significant relationship of H. pylori infection with both colon cancer and polyps.