The Geographic Variance of Helicobacter Pylori Infection in Europe and its Impact on the Incidence of Gastric Cancer

*Ayse Nilüfer Özaydın

Department of Public Health, Medical Faculty, Marmara University, Istanbul, Turkey
*Correspondence to nozaydin@gmail.com

Disclosure: No potential conflict of interest.
Received: 04.05.14 Accepted: 12.08.14
Citation: EMJ Gastroenterol. 2014;3:94-102.

Abstract

The discovery of Helicobacter pylori was hopeful as this agent was included in the list of ‘preventable- infectious carcinogens’, and many non-treatable gastroduodenal disorders with uncertain causes became treatable infectious diseases. Nevertheless, nowadays frequent antibiotic resistance is observed among H. pylori infections, sometimes as high as 95%. H. pylori is a bacteria that existed for a very long time, which was only recognised in the last 30 years. It can cause a variety of symptoms leading to gastroduodenal disorders from chronic inflammation in the gastrointestinal system to non-cardia gastric cancer. It is acquired in the early years of life and infection is commonly lifelong. The accepted primary route of transmission is person-to-person contact because humans are the only known significant reservoir of H. pylori. The target cell of H. pylori is the gastric mucus secreting cell. The prevalence in Europe shows a huge variety with almost all studies showing a decreasing trend. During childhood the highest prevalence was from Turkey (56.6%) and the lowest was from Czech Republic (4.8%). Among adults, the overall prevalence was found to be between 18.3% (Denmark) and 82.5% (Turkey), with substantial country-to-country variations. The prevalence rate differs by socioeconomic lifestyle characteristics and also genomic structure; it is also higher in less developed countries/populations. While the more commonly used test to determine H. pylori infection is serology, immunoglobulin G by enzyme-linked immunosorbent assay, the urea breath test (UBT), and stool antigen testing are non- invasive tests which are also recommended.

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