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Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile
BACKGROUND: Regional variations in gastric cancer incidence are not explained by prevalence of Helicobacter pylori, the main cause of the disease, with several areas presenting high H. pylori prevalence but low gastric cancer incidence. The IARC worldwide H. pylori prevalence surveys (ENIGMA) aim at...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478833/ https://www.ncbi.nlm.nih.gov/pubmed/32898138 http://dx.doi.org/10.1371/journal.pone.0237515 |
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author | Herrero, Rolando Heise, Katy Acevedo, Johanna Cook, Paz Gonzalez, Claudia Gahona, Jocelyne Cortés, Raimundo Collado, Luis Beltrán, María Enriqueta Cikutovic, Marcos Gonzalez, Paula Murillo, Raul Leja, Marcis Megraud, Francis Hernandez, Maria de la Luz Barbier, Sylvaine Park, Jin Young Ferreccio, Catterina |
author_facet | Herrero, Rolando Heise, Katy Acevedo, Johanna Cook, Paz Gonzalez, Claudia Gahona, Jocelyne Cortés, Raimundo Collado, Luis Beltrán, María Enriqueta Cikutovic, Marcos Gonzalez, Paula Murillo, Raul Leja, Marcis Megraud, Francis Hernandez, Maria de la Luz Barbier, Sylvaine Park, Jin Young Ferreccio, Catterina |
author_sort | Herrero, Rolando |
collection | PubMed |
description | BACKGROUND: Regional variations in gastric cancer incidence are not explained by prevalence of Helicobacter pylori, the main cause of the disease, with several areas presenting high H. pylori prevalence but low gastric cancer incidence. The IARC worldwide H. pylori prevalence surveys (ENIGMA) aim at systematically describing age and sex-specific prevalence of H. pylori infection around the world and generating hypotheses to explain regional variations in gastric cancer risk. METHODS: We selected age- and sex-stratified population samples in two areas with different gastric cancer incidence and mortality in Chile: Antofagasta (lower rate) and Valdivia (higher rate). Participants were 1–69 years old and provided interviews and blood for anti-H. pylori antibodies (IgG, VacA, CagA, others) and atrophy biomarkers (pepsinogens). RESULTS: H. pylori seroprevalence (Age-standardized to world population) and antibodies against CagA and VacA were similar in both sites. H. pylori seroprevalence was 20% among children <10 years old, 40% among 10–19 year olds, 60% in the 20–29 year olds and close to or above 80% in those 30+ years. The comparison of the prevalence of known and potential H. pylori cofactors in gastric carcinogenesis between the high and the low risk area showed that consumption of chili products was significantly higher in Valdivia and daily non-green vegetable consumption was more common in Antofagasta. Pepsinogen levels suggestive of gastric atrophy were significantly more common and occurred at earlier ages in Valdivia, the higher risk area. In a multivariate model combining both study sites, age, chili consumption and CagA were the main risk factors for gastric atrophy. CONCLUSIONS: The prevalence of H. pylori infection and its virulence factors was similar in the high and the low risk area, but atrophy was more common and occurred at younger ages in the higher risk area. Dietary factors could partly explain higher rates of atrophy and gastric cancer in Valdivia. IMPACT: The ENIGMA study in Chile contributes to better understanding regional variations in gastric cancer incidence and provides essential information for public health interventions. |
format | Online Article Text |
id | pubmed-7478833 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-74788332020-09-18 Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile Herrero, Rolando Heise, Katy Acevedo, Johanna Cook, Paz Gonzalez, Claudia Gahona, Jocelyne Cortés, Raimundo Collado, Luis Beltrán, María Enriqueta Cikutovic, Marcos Gonzalez, Paula Murillo, Raul Leja, Marcis Megraud, Francis Hernandez, Maria de la Luz Barbier, Sylvaine Park, Jin Young Ferreccio, Catterina PLoS One Research Article BACKGROUND: Regional variations in gastric cancer incidence are not explained by prevalence of Helicobacter pylori, the main cause of the disease, with several areas presenting high H. pylori prevalence but low gastric cancer incidence. The IARC worldwide H. pylori prevalence surveys (ENIGMA) aim at systematically describing age and sex-specific prevalence of H. pylori infection around the world and generating hypotheses to explain regional variations in gastric cancer risk. METHODS: We selected age- and sex-stratified population samples in two areas with different gastric cancer incidence and mortality in Chile: Antofagasta (lower rate) and Valdivia (higher rate). Participants were 1–69 years old and provided interviews and blood for anti-H. pylori antibodies (IgG, VacA, CagA, others) and atrophy biomarkers (pepsinogens). RESULTS: H. pylori seroprevalence (Age-standardized to world population) and antibodies against CagA and VacA were similar in both sites. H. pylori seroprevalence was 20% among children <10 years old, 40% among 10–19 year olds, 60% in the 20–29 year olds and close to or above 80% in those 30+ years. The comparison of the prevalence of known and potential H. pylori cofactors in gastric carcinogenesis between the high and the low risk area showed that consumption of chili products was significantly higher in Valdivia and daily non-green vegetable consumption was more common in Antofagasta. Pepsinogen levels suggestive of gastric atrophy were significantly more common and occurred at earlier ages in Valdivia, the higher risk area. In a multivariate model combining both study sites, age, chili consumption and CagA were the main risk factors for gastric atrophy. CONCLUSIONS: The prevalence of H. pylori infection and its virulence factors was similar in the high and the low risk area, but atrophy was more common and occurred at younger ages in the higher risk area. Dietary factors could partly explain higher rates of atrophy and gastric cancer in Valdivia. IMPACT: The ENIGMA study in Chile contributes to better understanding regional variations in gastric cancer incidence and provides essential information for public health interventions. Public Library of Science 2020-09-08 /pmc/articles/PMC7478833/ /pubmed/32898138 http://dx.doi.org/10.1371/journal.pone.0237515 Text en © 2020 Herrero et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Herrero, Rolando Heise, Katy Acevedo, Johanna Cook, Paz Gonzalez, Claudia Gahona, Jocelyne Cortés, Raimundo Collado, Luis Beltrán, María Enriqueta Cikutovic, Marcos Gonzalez, Paula Murillo, Raul Leja, Marcis Megraud, Francis Hernandez, Maria de la Luz Barbier, Sylvaine Park, Jin Young Ferreccio, Catterina Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile |
title | Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile |
title_full | Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile |
title_fullStr | Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile |
title_full_unstemmed | Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile |
title_short | Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile |
title_sort | regional variations in helicobacter pylori infection, gastric atrophy and gastric cancer risk: the enigma study in chile |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478833/ https://www.ncbi.nlm.nih.gov/pubmed/32898138 http://dx.doi.org/10.1371/journal.pone.0237515 |
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