H. pylori Infection linked to Colorectal Cancer, suggests Lancet study

A new study published in the journal of Lancet eClinical Medicine showed that Helicobacter pylori (H. pylori) infection might be a major risk factor for colorectal cancer development.

Recent studies points to a potential connection between colorectal cancer risk and Helicobacter pylori (H. pylori) infection. Therefore, this investigation was carried to investigate the relationship between H. pylori infection, anti-H. pylori medication, and colorectal cancer and its precursor, adenoma.

A total of 3,475 individuals underwent colonoscopies and H. pylori testing as part of a screening program in Zhejiang Province, China, between March 8 and December 29, 2023, as part of the observational study portion. The relationships between H. pylori infection and the risk of colorectal cancer and adenoma were examined using logistic regression models.

The relationships between H. pylori infection, anti-H. pylori therapy, and the risk of colorectal cancer and adenoma were also the subject of a meta-analysis. From the beginning until April 9, 2025, 3 databases (PubMed, Embase, and the Cochrane Library) were searched for pertinent research.

The Newcastle–Ottawa Scale for case-control and cohort studies, as well as the guidelines provided by the Agency for Healthcare Research and Quality for cross-sectional studies, were used to assess the quality of the research. I2 statistics were used to quantify heterogeneity, and subgroup analyses were carried out to find possible causes.

This study evaluated publication bias using funnel plots and corrected for potential bias using Duval and Tweedie's "trim-and-fill" methodology. The Grading of Recommendations, Assessment, Development, and Evaluation approach was used to gauge the degree of certainty in the evidence.

In comparison to normal or non-adenomatous lesions (n = 2199), this study discovered a statistically significant correlation between H. pylori infection and the risk of colorectal cancer (n = 31, OR = 2.57, 95% CI: 1.26–5.39) and adenoma (n = 1245, OR = 1.37, 95% CI: 1.19–1.59), particularly for advanced adenoma (n = 486, OR = 1.94, 95% CI: 1.59–2.38).

H. pylori infection had a positive correlation with colorectal cancer (OR = 1.59, 95% CI: 1.39–1.82, I2 = 89%) and adenoma (OR = 1.47, 95% CI: 1.36–1.59, I2 = 88%), particularly with advanced adenoma (OR = 1.77, 95% CI: 1.56–2.00, I2 = 65%), according to a meta-analysis of this and 54 other studies, which included 48,945,236 participants.

The overall odds ratio (OR) for colorectal neoplasia (adenoma or colon cancer) was 1.49 (95% CI: 1.39–1.60, I2 = 91%). Overall, this study found a considerably increased incidence of colorectal cancer and adenoma in people who had H. pylori infection, indicating that H. pylori infection might be a significant risk factor for colorectal cancer development.

Source:

Li, X., Tao, H.-Q., Zhao, J.-E., Zhu, J., Du, L.-B., Gerhard, M., & Li, W.-Q. (2025). Helicobacter pylori infection, anti-Helicobacter pylori treatment and risk of colorectal cancer and adenoma: an observational study and a meta-analysis. eClinicalMedicine, 84(103299), 103299. https://doi.org/10.1016/j.eclinm.2025.103299