Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 28, 2024; 30(48): 5194-5197
Published online Dec 28, 2024. doi: 10.3748/wjg.v30.i48.5194
Revaluation of Helicobacter pylori's role in esophageal carcinoma: A call for comprehensive research
Jemila Ibrahim Omer, Alexander Habte Habtemariam
Jemila Ibrahim Omer, Department of Internal Medicine, Orotta School of Medicine, Asmara 291-1, Eritrea
Alexander Habte Habtemariam, Department of Surgery, Assab Military Hospital, Assab 291-1, Southern Red-sea Region, Eritrea
Author contributions: Omer JI and Habtemariam AH both contributed significantly to the development of this manuscript; Omer JI conceptualized the idea and wrote the initial draft of the manuscript; Habtemariam AH provided critical revisions and expert input on the methodology and discussion of strain-specific virulence factors and confounding variables; Both authors reviewed the manuscript, approved the final version, and agree to be accountable for all aspects of the work.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jemila Ibrahim Omer, MD, Doctor, Department of Internal Medicine, Orotta School of Medicine, Aarerib Street, Asmara 291-1, Eritrea. jemilaomer1988@gmail.com
Received: August 5, 2024
Revised: September 25, 2024
Accepted: November 5, 2024
Published online: December 28, 2024
Processing time: 115 Days and 21.6 Hours
Abstract

The study by López-Gómez et al, reports a significantly low prevalence (4.5%) of Helicobacter pylori (H. pylori) infection in esophageal cancer patients, contrasting sharply with the general population's infection rate. This finding challenges the established negative association between H. pylori and gastric malignancies, suggesting a potential protective role of H. pylori against esophageal carcinoma, particularly in the context of widespread proton pump inhibitor use. However, the study’s retrospective nature, single-center design, and small sample size limit the generalizability of the findings and raise concerns about selection bias and statistical power. Diagnostic methods primarily based on histology may not detect all cases, especially those with prior antibiotic or proton pump inhibitor use. Additionally, the study does not account for various confounding factors such as dietary habits, socio-economic status, and genetic predispositions that could affect the association between H. pylori and esophageal carcinoma. Further research with larger, more diverse cohorts and comprehensive data collection is necessary to clarify the complex relationship between H. pylori and esophageal carcinoma and substantiate these preliminary findings.

Keywords: Helicobacter pylori; Esophageal carcinoma; Helicobacter pylori prevalence; Gastric malignancies; Proton pump inhibitors; Retrospective observational study

Core Tip: The implication that widespread Helicobacter pylori (H. pylori) eradication could contribute to a rise in esophageal cancer cases warrants further investigation. Additionally, a more thorough investigation of lifestyle, dietary habits, socio-economic status, and genetic predispositions as potential confounding factors could provide clarity in understanding the relationship between H. pylori infection and esophageal cancer. The widespread nature of H. pylori worldwide and its association with many gastrointestinal malignancies make it a critical area of focus for future clinical research.