Population-based strategies for Helicobacter pylori-associated disease management: Latin American perspective

Abstract

In 2012 almost 65 ‖ of all cancer deaths occurred in less developed regions of the world, including Latin America, and this frequency is predicted to increase in the coming years. We aim to offer an outlook of the burden that gastric cancer represents for the region, the challenges faced, actions taken by some countries, and regional efforts to deal with the problem. Latin America is a region with contrasting gastric cancer mortality rates, with areas presenting among the highest in the world (Central America and the Andean countries) and areas with the lowest mortality rates (Paraguay and Argentina). In Colombia, a chemoprevention trial was carried out in a high–risk region to investigate whether anti-Helicobacter pylori therapy, vitamin supplements, or both prevented the progression of gastric premalignant lesions. All three interventions resulted in significant regression of precancerous lesions. A clinical trial in seven Latin American regions proved the feasibility of H. pylori eradication in community–based programs using less expensive and locally available generic drugs. A multidisciplinary Latin American team worked on a consensus to deal with the problem, and they stated that “the potential benefit of eradicating H. pylori in primary prevention of gastric cancer is highly suggested. However, there is insufficient evidence to justify large–scale implementation in the general population.” In 2013; IARC gathered worldwide experts to make recommendations on H. pylori treatment for gastric cancer prevention. The group recommended the inclusion of gastric cancer prevention in national cancer programs, including controlled interventions for H. pylori eradication, particularly in high-incidence areas like Latin America.