Gastric cancer mortality and prevalence of Helicobacter pylori infection in Portugal

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Gastric cancer mortality and prevalence of Helicobacter pylori infection in Portugal

Thursday, 03.09.2015

The consistently high prevalence of Helicobacter pylori infection observed across age groups and studies carried out in different periods shows a large potential for decrease in the burden of gastric cancer in Portugal, and the downward trends in mortality rates may be expected to remain in the next decades.

 

 

Authors and affiliations:

Samantha Morais1, Ana Ferro1, Ana Bastos1, Clara Castro1,2, Nuno Lunet1,3, Bárbara Peleteiro1,3

1 EPIUnit – Institute of Public Health, University of Porto, Porto, Portugal

2 North Region Cancer Registry (RORENO) – Portuguese Oncology Institute, Porto, Portugal

3 Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal

 

 

Abstract:

Portugal has the highest gastric cancer mortality rates in Western Europe, along with high prevalences of Helicobacter pylori infection. Monitoring their trends is essential to predict the burden of this cancer. We aimed to quantify time trends in gastric cancer mortality in Portugal and in each administrative region, and to compute short-term predictions, as well as to describe the prevalence of H. pylori infection, through a systematic review. Joinpoint analyses were used to identify significant changes in sex-specific trends in gastric cancer age-standardized mortality rates (ASMR) and to estimate annual percent changes (APC). The most recent trends were considered to compute estimates up to 2020 by adjusting Poisson regression models. We searched PubMed and IndexRMP to identify studies carried out in Portugal reporting the prevalence of H. pylori. Gastric cancer mortality has been decreasing in Portugal since 1971 in men (from ASMR=55.3/100 000; APC=-2.4, 95% confidence interval: -2.5 to -2.3) and since 1970 in women (from ASMR=28.0/100 000; APC=-2.8, 95% confidence interval: -2.9 to -2.7), although large regional differences were observed. Predicted ASMR for 2015 and 2020 were 18.8/100 000 and 16.7/100 000 for men and 8.5/100 000 and 7.4/100 000 for women, respectively. The prevalence of H. pylori varied from almost 5% at 0.5-2 years to just over 90% at 70 years or more. No consistent variation was observed since the 1990s. The downward trends in mortality rates are expected to remain in the next decades. The high prevalence of H. pylori infection across age groups and studies from different periods shows a large potential for decrease in the burden of gastric cancer in Portugal.

 

 

Journal:European Journal of Cancer Prevention

 

 

Link:http://journals.lww.com/eurjcancerprev/Abstract/publishahead/Trends_in_gastric_cancer_mortality_and_in_the.99483.aspx