Su1215 - Gastric Pathology Follow-Up Study in Canadian Arctic Communities

Zanten, Sander Veldhuyzen van; Girgis, Safwat; Munday, Rachel; Chang, Hsiu-Ju; Fagan-Garcia, Katharine; Assi, Ali; Wang, Ting; Goodman, Karen J.

doi:10.1016/s0016-5085(18)31915-2

Cited by 2 publications

(1 citation statement)

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“…In keeping with community-university research agreements, all results have been disseminated within participating communities to address voiced concerns and support community efforts to advocate for relevant resources and policies. In addition, our collaborative team has used these disease burden results, along with results from treatment trials and longitudinal follow-up [17, 42], to create Hp clinical guidelines (not yet published) specific to healthcare practitioners serving Arctic communities in Canada.…”

Section: Discussionmentioning

confidence: 99%

Burden of disease from Helicobacter pylori infection in western Canadian Arctic communities

et al. 2019

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Background Indigenous communities across the circumpolar north have elevated H. pylori ( Hp ) prevalence and stomach cancer incidence. We aimed to describe the Hp -associated disease burden among western Canadian Arctic participants in community-driven projects that address concerns about health risks from Hp infection. Methods During 2008–2013, participants underwent Hp screening by urea breath test and gastroscopy with gastric biopsies. We estimated Hp prevalence and prevalence by Hp status of endoscopic and histopathologic diagnoses. Results Among 878 participants with Hp status data, Hp prevalence was: 62% overall; 66% in 740 Indigenous participants; 22% in 77 non-Indigenous participants (61 participants did not disclose ethnicity); 45% at 0–14 years old, 69% at 15–34 years old, and 61% at 35–96 years old. Among 309 participants examined endoscopically, visible mucosal lesions were more frequent in the stomach than the duodenum: the gastric to duodenal ratio was 2 for inflammation, 8 for erosions, and 3 for ulcers. Pathological examination in 308 participants with gastric biopsies revealed normal gastric mucosa in 1 of 224 Hp -positive participants and 77% (65/84) of Hp -negative participants with sharp contrasts in the prevalence of abnormalities between Hp -positive and Hp -negative participants, respectively: moderate-severe active gastritis in 50 and 0%; moderate-severe chronic gastritis in 91 and 1%; atrophic gastritis in 43 and 0%; intestinal metaplasia in 17 and 5%. Conclusions The observed pattern of disease is consistent with increased risk of stomach cancer and reflects substantial inequity in the Hp -associated disease burden in western Arctic Canadian hamlets relative to most North American settings. This research adds to evidence that demonstrates the need for interventions aimed at reducing health risks from Hp infection in Indigenous Arctic communities.

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Section: Discussionmentioning

confidence: 99%