Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile.

<h4>Background</h4>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 surv...

Full description

Bibliographic Details
Main Authors: Rolando Herrero, Katy Heise, Johanna Acevedo, Paz Cook, Claudia Gonzalez, Jocelyne Gahona, Raimundo Cortés, Luis Collado, María Enriqueta Beltrán, Marcos Cikutovic, Paula Gonzalez, Raul Murillo, Marcis Leja, Francis Megraud, Maria de la Luz Hernandez, Sylvaine Barbier, Jin Young Park, Catterina Ferreccio, ENIGMA Chile study group
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0237515
_version_ 1797743322504101888
author Rolando Herrero
Katy Heise
Johanna Acevedo
Paz Cook
Claudia Gonzalez
Jocelyne Gahona
Raimundo Cortés
Luis Collado
María Enriqueta Beltrán
Marcos Cikutovic
Paula Gonzalez
Raul Murillo
Marcis Leja
Francis Megraud
Maria de la Luz Hernandez
Sylvaine Barbier
Jin Young Park
Catterina Ferreccio
ENIGMA Chile study group
author_facet Rolando Herrero
Katy Heise
Johanna Acevedo
Paz Cook
Claudia Gonzalez
Jocelyne Gahona
Raimundo Cortés
Luis Collado
María Enriqueta Beltrán
Marcos Cikutovic
Paula Gonzalez
Raul Murillo
Marcis Leja
Francis Megraud
Maria de la Luz Hernandez
Sylvaine Barbier
Jin Young Park
Catterina Ferreccio
ENIGMA Chile study group
author_sort Rolando Herrero
collection DOAJ
description <h4>Background</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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.<h4>Conclusions</h4>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.<h4>Impact</h4>The ENIGMA study in Chile contributes to better understanding regional variations in gastric cancer incidence and provides essential information for public health interventions.
first_indexed 2024-03-12T14:53:49Z
format Article
id doaj.art-927e916ba0ac4b6bb3b79069e952b1bc
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-03-12T14:53:49Z
publishDate 2020-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-927e916ba0ac4b6bb3b79069e952b1bc2023-08-15T05:31:47ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01159e023751510.1371/journal.pone.0237515Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile.Rolando HerreroKaty HeiseJohanna AcevedoPaz CookClaudia GonzalezJocelyne GahonaRaimundo CortésLuis ColladoMaría Enriqueta BeltránMarcos CikutovicPaula GonzalezRaul MurilloMarcis LejaFrancis MegraudMaria de la Luz HernandezSylvaine BarbierJin Young ParkCatterina FerreccioENIGMA Chile study group<h4>Background</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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.<h4>Conclusions</h4>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.<h4>Impact</h4>The ENIGMA study in Chile contributes to better understanding regional variations in gastric cancer incidence and provides essential information for public health interventions.https://doi.org/10.1371/journal.pone.0237515
spellingShingle Rolando Herrero
Katy Heise
Johanna Acevedo
Paz Cook
Claudia Gonzalez
Jocelyne Gahona
Raimundo Cortés
Luis Collado
María Enriqueta Beltrán
Marcos Cikutovic
Paula Gonzalez
Raul Murillo
Marcis Leja
Francis Megraud
Maria de la Luz Hernandez
Sylvaine Barbier
Jin Young Park
Catterina Ferreccio
ENIGMA Chile study group
Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile.
PLoS ONE
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
url https://doi.org/10.1371/journal.pone.0237515
work_keys_str_mv AT rolandoherrero regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT katyheise regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT johannaacevedo regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT pazcook regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT claudiagonzalez regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT jocelynegahona regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT raimundocortes regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT luiscollado regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT mariaenriquetabeltran regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT marcoscikutovic regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT paulagonzalez regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT raulmurillo regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT marcisleja regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT francismegraud regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT mariadelaluzhernandez regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT sylvainebarbier regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT jinyoungpark regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT catterinaferreccio regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile
AT enigmachilestudygroup regionalvariationsinhelicobacterpyloriinfectiongastricatrophyandgastriccancerrisktheenigmastudyinchile