Helicobacter pylori and Gastric Cancer: Timing and Impact of Preventive Measures
Helicobacter pylori (H. pylori) is a Gram negative spiraliform bacterium that is commonly found in the stomach. H. pylori infection is still one of the world’s most frequent infections, present in the stomachs of approximately one-half of the world’s peop
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Helicobacter pylori and Gastric Cancer: Timing and Impact of Preventive Measures Marino Venerito, Riccardo Vasapolli, and Peter Malfertheiner
Gastric Cancer: Classification GC is classified anatomically as proximal (cardia) and distal (non-cardia). According to the Lauren classification gastric cancer can be subdivided in two distinct pathological entities: the intestinal type and the diffuse type [1]. Sporadic non-cardia GC of both intestinal and diffuse type is commonly associated with H. pylori infection, whereas the association of this infection with cardia GC is less well defined. In the present chapter we give a special emphasis to non-cardia GC because of its close association with H. pylori infection.
Gastric Cancer: Epidemiological Aspects H. pylori infection is the main risk factor involved in gastric carcinogenesis and subsequently GC incidence tends to mirror the prevalence rate of H. pylori infection [2]. GC represents the third leading cause of cancer related death in the world [3]. Despite the fact that a continuing decrease in the incidence of gastric carcinoma has been observed during the last decades, this malignancy still represents an important health burden in all almost populations and causes more than 720,000 deaths per year globally. There is a substantial geographic variation in GC incidence, with the highest rates reported in Eastern Asia (age-standardized incidence 35.4 per 100,000 in men, 13.8 per 100,000 in women). High incidence and mortality rates are also observed in both sexes in Central and Eastern Europe and in Central and South America [4]. Men have approximately twice the risk of developing stomach cancer, compared to women [5]. Outlook for patients with gastric cancer remains poor, principally due to the advanced stage of the disease frequently observed at first diagnosis. The mortality rates for gastric adenocarcinoma are similar in most Western countries with relative 5-year survival rates generally lower than 30 % [6]. M. Venerito • R. Vasapolli • P. Malfertheiner, M.D. (*) Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg 39120, Germany e-mail: [email protected] © Springer International Publishing Switzerland 2016 M. Jansen, N.A. Wright (eds.), Stem Cells, Pre-neoplasia, and Early Cancer of the Upper Gastrointestinal Tract, Advances in Experimental Medicine and Biology 908, DOI 10.1007/978-3-319-41388-4_20
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In contrast, the survival data from Eastern countries including Korea and Japan are more favorable with overall 5-year survival rates up to 60 %, likely following the adopted mass screening programs that facilitate earlier diagnosis of the disease [7].
H. pylori as Principal Trigger of Gastric Carcinogenesis Gastric carcinogenesis is a complex multistep process in which different etiologic factors are implicated. Numerous lifestyle and dietetic habits have been indicated as a risk factor for non-cardia GC. High intake of salt as well as traditional saltpreser
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