Community-driven projects have characterizedHelicobacter pylori(Hp) infection in Indigenous communities in the Northwest Territories (NT) and Yukon (YT), Canada. These projects address concerns about the frequent diagnosis ofHpinfection among community members and its relation to gastric cancer deaths, perceived to occur with alarming frequency in this region. Projects included breath-test screening forHpinfection, gastroscopy with gastric biopsies, and treatment to eliminateHpinfection. Previous project results showed a high prevalence of stomach pathologies associated with increased cancer risk amongHp-positive participants at baseline. This analysis describes changes in precancerous gastric pathologies in project participants who had gastroscopy before baseline treatment during 2008–2013 and again in 2017. Throughout the study period, the same pathologist gradedHpdensity, active gastritis, chronic gastritis, atrophic gastritis, and intestinal metaplasia using the updated Sydney System. Of 310 participants from three communities with baseline pathology data, 69 had follow-up pathology data. Relative to baseline, the prevalence ofHpinfection and precancerous gastric pathology was substantially lower at follow-up; most participants who wereHp-positive at baseline andHp-negative at follow-up had reduced severity of active, chronic, and/or atrophic gastritis at follow-up. Though follow-up numbers are small, these results yield evidence that successfulHptreatment has the potential to reduce the risk of gastric cancer in Arctic Indigenous communities.
社区驱动项目描述了加拿大西北地区（NT）和育空地区（YT）原住民社区中幽门螺杆菌（Hp）感染的特征。这些项目针对社区成员中Hp感染频繁诊断及其与胃癌死亡关系的担忧，该地区胃癌死亡被认为以惊人频率发生。项目包括Hp感染的呼气测试筛查、胃镜检查与胃活检，以及根除Hp感染的治疗。先前项目结果显示，基线时Hp阳性参与者中与癌症风险相关的胃病理患病率较高。本分析描述了2008年至2013年间基线治疗前接受胃镜检查并在2017年再次检查的项目参与者中癌前胃病理的变化。在整个研究期间，同一位病理学家使用更新悉尼系统对Hp密度、活动性胃炎、慢性胃炎、萎缩性胃炎和肠上皮化生进行分级。在三个社区中具有基线病理数据的310名参与者中，69名拥有随访病理数据。相对于基线，随访时Hp感染和癌前胃病理的患病率显著降低；大多数基线Hp阳性而随访Hp阴性的参与者在随访时活动性、慢性和/或萎缩性胃炎的严重程度减轻。尽管随访数量较少，但这些结果提供证据表明，成功的Hp治疗有望降低北极原住民社区的胃癌风险。
肿瘤(癌症)患者之家