Download the full-sized PDF of Disease manifestations of Helicobacter pylori infection in Arctic Canada: using epidemiology to address community concerns.Download the full-sized PDF



Permanent link (DOI):


Export to: EndNote  |  Zotero  |  Mendeley


This file is in the following communities:

CANHelp Working Group


This file is in the following collections:

Journal Articles (CANHelp Working Group)

Disease manifestations of Helicobacter pylori infection in Arctic Canada: using epidemiology to address community concerns. Open Access


Author or creator
Cheung, J.
Goodman, K.J.
Girgis, S.
Bailey, R.
Morse, J.
Fedorak, R.N.
Geary, J.
Fagan-Garcia, K.
van Zanten, S.V.
Additional contributors
Helicobacter pylori
Aboriginal health
gastric abnormalities
Type of item
Journal Article (Published)
Objectives Helicobacter pylori infection, linked to gastric cancer, is responsible for a large worldwide disease burden. H pylori prevalence and gastric cancer rates are elevated among indigenous Arctic communities, but implementation of prevention strategies is hampered by insufficient information. Some communities in northern Canada have advocated for H pylori prevention research. As a first step, community-driven research was undertaken to describe the H pylori-associated disease burden in concerned communities. Design Participants in this cross-sectional study completed a clinical interview and gastroscopy with gastric biopsies taken for histopathological examination in February 2008. Setting Study procedures were carried out at the health centre in Aklavik, Northwest Territories, Canada (population ∼600). Participants All residents of Aklavik were invited to complete a clinical interview and gastroscopy; 194 (58% female participants; 91% Aboriginal; age range 10–80 years) completed gastroscopy and had gastric biopsies taken. Primary and secondary outcome measures This analysis estimates the prevalence of gastric abnormalities detected by endoscopy and histopathology, and associations of demographic and clinical variables with H pylori prevalence. Results Among 194 participants with evaluable gastric biopsies, 66% were H pylori-positive on histology. Among H pylori-positive participants, prevalence was 94% for acute gastritis, 100% for chronic gastritis, 21% for gastric atrophy and 11% for intestinal metaplasia of the gastric mucosa, while chronic inflammation severity was mild in 9%, moderate in 47% and severe in 43%. In a multivariable model, H pylori prevalence was inversely associated with previous gastroscopy, previous H pylori therapy and aspirin use, and was positively associated with alcohol consumption. Conclusions In this population, H pylori-associated gastric histopathology shows a pattern compatible with elevated risk of gastric cancer. These findings demonstrate that local concern about health risks from H pylori is warranted and provide an example of how epidemiological research can address health priorities identified by communities.
Date created
License information
Creative Commons Attribution-Non-Commercial 3.0 Unported

Citation for previous publication
Cheung J, Goodman KJ, Girgis S, Bailey R, Morse J, Fedorak RN, Geary J, Fagan-Garcia K, van Zanten SV, CANHelp Working Group. Disease manifestations of Helicobacter pylori infection in Arctic Canada: using epidemiology to address community concerns. BMJ Open 2014; 4: e003689 doi:10.1136/bmjopen-2013-003689
Link to related item

File Details

Date Uploaded
Date Modified
Audit Status
Audits have not yet been run on this file.
File format: pdf (Portable Document Format)
Mime type: application/pdf
File size: 824668
Last modified: 2015:10:12 20:43:12-06:00
Filename: BMJO_2014_4.pdf
Original checksum: eac8994ce383880bff56e9756c3d6c2e
Well formed: false
Valid: false
Status message: Unexpected error in findFonts java.lang.ClassCastException: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject cannot be cast to edu.harvard.hul.ois.jhove.module.pdf.PdfDictionary offset=7352
Status message: Invalid Annotation list offset=797439
Activity of users you follow
User Activity Date