ArticlePloS one2020
Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 25 citations in OpenAlex.
- PVT1 and ZFAS1 lncRNAs expressions and their biomarker value in gastric cancer tissue sampling among Iranian population.Molecular biology reports · 2021Trial
- Chronic hepatitis B virus infection and the risk of extrahepatic malignancies: an updated review of epidemiology, mechanisms, and clinical implications.Virology journal · 2026Review
- Regional variations in serum pepsinogen levels and their influencing factors: a multi-center cross-sectional study.Scientific reports · 2026Article
- Rethinking gastric carcinogenesis: a multiscale ecological model of risk beyondFrontiers in microbiology · 2026Review
- Descriptive epidemiology of gastric cancer in Costa Rica from 1990 to 2022 and projection of deaths to 2050: a population-based study.Lancet regional health. Americas · 2025Article
- Spatial Study of TLR4, TLR5 and TLR9 in Gastric Premalignant Lesions Before and AfterInternational journal of molecular sciences · 2025Article
- Social gradient and rural-urban disparities in cancer mortality in Costa Rica.Cancer epidemiology · 2024Article
- Historical and Molecular Perspectives on the Presence ofInternational journal of molecular sciences · 2024Review
- Autophagy-Related GeneJournal of clinical medicine · 2024Article
- Article
- Polymorphism in autophagy-related genes LRP1 and CAPZA1 may promote gastric mucosal atrophy.Genes and environment : the official journal of the Japanese Environmental Mutagen Society · 2023Article
- Overexpression of HOXA-AS2 LncRNA in Patients with Gastric Cancer and Its Association with Helicobacter pylori Infection.Journal of gastrointestinal cancer · 2022Article
- Gastrointestinal microbiome andWorld journal of gastroenterology · 2022Article
- Article
- Helicobacter Pylori Infection Among Patients Attending Bule Hora University Teaching Hospital, Ethiopia: Five-Year Trends.Health services research and managerial epidemiologyArticle
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Authors and funding
19 authors at 10 institutions in 4 countries.
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Abstract
backgroundRegional 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.
methodsWe 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).
resultsH. 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.
conclusionsThe 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.
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