Editorial: Helicobacter pylori and gastric cancer in Alaskan Natives: Time to stop studying H. pylori and to eradicate it

Lee, Yi–Chia; Asaka, Masahiro; Graham, David Y.

doi:10.1111/hel.12478

Cited by 6 publications

(5 citation statements)

References 8 publications

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“…2 Exposure to more risk factors from social habits, lifestyle, and Helicobacter pylori infection has been considered the cause. [3][4][5] However, even though gastric cancer has been repeatedly shown to be preventable by eliminating risk factors, [6][7][8][9][10][11][12] such policies are rarely designed for Indigenous peoples. Possible obstacles may include the lack of Indigenous health statistics, inadequate access to care, difficulty in modifying social habits and lifestyles, and the presence of environmental and cultural barriers.…”

Section: Introductionmentioning

confidence: 99%

Planning mass eradication of Helicobacter pylori infection for indigenous Taiwanese peoples to reduce gastric cancer

Bair

Chuang

Lei

et al. 2019

J of Gastro and Hepatol

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Background and Aim The aim of this study is to identify gastric cancer burden in Indigenous Taiwanese peoples and conduct a project to evaluate how to reduce the disparities most effectively in Indigenous communities. Methods First, we quantified the health disparities in gastric cancer in Indigenous peoples using data from the cancer registries during the period of 2006–2014. Second, we identified parameters that might be associated with Helicobacter pylori infection or help identify a good eradication strategy. Results Gastric cancer incidence (24.4 vs 12.3 per 100 000 person‐years) and mortality rates (15.8 vs 6.8 per 100 000 person‐years) were higher in Indigenous than in non‐Indigenous, with 2.19‐fold (95% confidence interval [CI]: 2.06–2.33) and 2.47‐fold (2.28–2.67) increased risk, respectively. In Indigenous communities, H. pylori infection was more prevalent in Indigenous than in non‐Indigenous (59.4% vs 31.5%, P < 0.01). Regression analyses consistently showed that either the mountain or plain Indigenous had 1.89‐fold (95% CI: 1.34–2.66) and 1.73‐fold (95% CI: 1.24–2.41) increased risk for H. pylori infection, respectively, as compared with non‐Indigenous, adjusting for other baseline characteristics. The high infection rates were similarly seen in young, middle‐aged, and older adults. Program eradication rates using clarithromycin‐based triple therapy were suboptimal (73.7%, 95% CI: 70.0–77.4%); the habits of smoking (1.70‐fold, 95% CI: 1.01–2.39) and betel nut chewing (1.54‐fold, 95% CI: 0.93–2.16) were associated with the higher risk of treatment failure. Conclusion Gastric cancer burden is higher in Indigenous Taiwanese peoples than in their non‐Indigenous counterparts. Eliminating the prevalent risk factor of H. pylori infection is a top priority to reduce this health disparity.

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Section: Introductionmentioning

confidence: 99%

Planning mass eradication of Helicobacter pylori infection for indigenous Taiwanese peoples to reduce gastric cancer

Bair

Chuang

Lei

et al. 2019

J of Gastro and Hepatol

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“…It is estimated to colonize the stomach mucosa of nearly half the human population (59). Field studies in the Canadian Arctic reported high rates of H. pylori among Indigenous communities compared with national counterparts (17,(60)(61)(62)(63)(64)(65). Prevalence among Indigenous communities in Yukon and NWT ranged from 58% to 69% (60).…”

Section: Discussionmentioning

confidence: 99%

Stomach Cancer Incidence and Mortality Trends among Circumpolar Nations

Simkin

Nash

Барчук

et al. 2021

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Stomach cancer incidence and mortality rates are declining across circumpolar nations, but the burden may not be distributed equally across subpopulations, including Indigenous peoples. Our objective was to examine stomach cancer incidence and mortality trends across circumpolar populations. Methods: Cancer incidence and mortality data from 1999–2016 were obtained from the Canadian Cancer Registry, Canadian Vital Statistics, CDC WONDER, NORDCAN, Northwestern Russian cancer registries, and National Cancer Reports. The direct method was used to calculate 10-year rolling age-standardized incidence and mortality rates to the world (WHO 2000–2025) and 2011 Canadian standard populations. Standardized incidence rate ratios (SRR) were calculated. Data were stratified by sex, year, and region. U.S. data were broken down by race [White; American Indian/Alaska Native (AIAN)]. Race data were not available from non-U.S. cancer registries. Results: Most populations showed declining incidence and mortality rates over time. Incidence rates among Greenland males and females, Alaska AIAN males and females, and Northern Canadian both sexes were elevated compared with regional counterparts and remained stable. The largest male SRR was observed among Alaska AIAN versus Alaska Whites [SRR = 3.82; 95% confidence interval (95% CI), 2.71–5.37]. The largest female SRR was observed among Alaska AIAN versus Alaska Whites (SRR = 4.10; 95% CI, 2.62–6.43). Conclusions: Despite stomach cancer incidence and mortality rates declining overall, some northern and Indigenous populations experience elevated and stable incidence and mortality rates. Impact: There is a need to address disparities observed among circumpolar subpopulations. Given similarities in incidence, mortality, and risk factor prevalence across circumpolar regions, addressing disparities could benefit from coordinated international action.

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“…]. In contrast, the US Center for Disease Control and Prevention (CDC) has repeatedly studied H. pylori infection in Native Americans and Alaskans (both high-risk populations) but has yet to implement any measures to systematically eradicate the infection from these indigent populations [15,16].…”

Section: Andandmentioning

confidence: 99%

“…In contrast, Taiwan and China, countries with high incidence of H. pylori and related diseases, have recently embarked on case finding based on screening families of infected individuals and high-risk groups [13 ▪ ,14 ▪▪ ]. In contrast, the US Center for Disease Control and Prevention (CDC) has repeatedly studied H. pylori infection in Native Americans and Alaskans (both high-risk populations) but has yet to implement any measures to systematically eradicate the infection from these indigent populations [15,16].…”

Section: Introductionmentioning

confidence: 99%

Controversies regarding management of Helicobacter pylori infections

Price,

Graham,

Tan

2023

Current Opinion in Gastroenterology

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Purpose of review The recognition that Helicobacter pylori should be considered and treated as an infectious disease has yet to fundamentally change diagnostic and treatment practices and has resulted in many controversies. Recent findings We discuss the following controversies: whether the current ‘per-patient’ approach to H. pylori testing based on symptoms should be expanded to include achieving population-level H. pylori eradication, whether H. pylori should be approached as an infectious gastrointestinal disease similar to that of other infectious diseases of similar severity and outcome, whether treatment of H. pylori should be primarily empiric or based on antibiotic susceptibility and locally proven successful therapies as are other infectious diseases, whether it is necessary to obtain confirmation of treatment success in every patient treated for H. pylori, and whether potassium-competitive acid blockers should replace proton pump inhibitors in H. pylori therapy. Summary Available guidelines and meta-analyses do not yet address H. pylori as an infectious disease. The diagnosis and management and treatment success of H. pylori infections trails behind that of other important infectious diseases. We provide new insights and propose changes in the traditional understanding required to modernize the management of H. pylori infections.

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Editorial: Helicobacter pylori and gastric cancer in Alaskan Natives: Time to stop studying H. pylori and to eradicate it

Cited by 6 publications

References 8 publications

Planning mass eradication of Helicobacter pylori infection for indigenous Taiwanese peoples to reduce gastric cancer

Planning mass eradication of Helicobacter pylori infection for indigenous Taiwanese peoples to reduce gastric cancer

Stomach Cancer Incidence and Mortality Trends among Circumpolar Nations

Controversies regarding management of Helicobacter pylori infections

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