Helicobacter pylori (H. pylori) infection is associated with an increased risk of colorectal cancer (CRC), especially in genetically susceptible individuals.
The risk is further elevated in individuals seropositive for key H. pylori virulence factors: CagA, HpaA, Omp, and HP0305.
H. pylori eradication treatment reduces CRC risk in the Shandong Intervention Trial (SIT) but shows benefit mainly among high genetic risk subgroups in the larger Mass Intervention Trial in Linqu (MITS).
Long-term follow-up up to nearly 30 years supports a sustained protective effect of successful H. pylori eradication in select populations.