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Large screening study clarifies Barrett’s esophagus risk factors

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Created On: 20/06/2026

Helicobacter pylori, Barrett’s esophagus

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Key take away

Large-scale screening evidence indicates that Barrett’s esophagus risk is driven more by sex and smoking status than by H. pylori infection.

Background

Barrett’s esophagus (BE) is a clinically significant precancerous condition often linked to long-standing gastroesophageal reflux disease (GERD), with affected individuals facing a greater risk of developing esophageal adenocarcinoma. Nikolaus Götz and his colleagues assessed the potential link between Helicobacter pylori (H. pylori) infection and BE prevalence in a large population of asymptomatic adults.

Method

A retrospective analysis of 4,074 asymptomatic adults who underwent upper gastrointestinal endoscopy for colorectal cancer was carried. The diagnosis of BE was established through endoscopic detection followed by histological confirmation of specialized intestinal metaplasia. H. pylori status was assessed histologically. Adjusted multivariable logistic regression analyses were conducted to examine the relationship, while interaction analyses assessed the potential impact of age, sex, metabolic syndrome, and proton pump inhibitor therapy on study outcomes.

Result

Table 1 summarizes the prevalence of BE and H.pylori infection status identified in the multivariable analysis.

Following multivariable adjustment for demographic, metabolic, and lifestyle-related factors, H. pylori infection was not identified as an independent predictor of BE. In contrast, male sex was identified as the most prominent independent risk factor for BE, while active smoking was also significantly associated with increased odds of disease.

Further subgroup and interaction analyses demonstrated consistent findings across different patient groups, with no significant influence of age, sex, metabolic syndrome, or proton pump inhibitor use on the observed relationship between H. pylori infection and BE.

Conclusion

They concluded that H. pylori infection was not significantly associated with the prevalence of BE after adjustment for relevant clinical and lifestyle factors. The findings suggested that current H. pylori status had limited clinical relevance in predicting BE risk, whereas male sex and active smoking remained important independent determinants of disease occurrence.