The Geographic Variance of Helicobacter Pylori Infection in Europe and its Impact on the Incidence of Gastric Cancer

Abstract

The discovery of Helicobacter pylori was hopeful as this agent was included in the list of ‘preventable- infectious carcinogens’, and many non-treatable gastroduodenal disorders with uncertain causes became treatable infectious diseases. Nevertheless, nowadays frequent antibiotic resistance is observed among H. pylori infections, sometimes as high as 95%. H. pylori is a bacteria that existed for a very long time, which was only recognised in the last 30 years. It can cause a variety of symptoms leading to gastroduodenal disorders from chronic inflammation in the gastrointestinal system to non-cardia gastric cancer. It is acquired in the early years of life and infection is commonly lifelong. The accepted primary route of transmission is person-to-person contact because humans are the only known significant reservoir of H. pylori. The target cell of H. pylori is the gastric mucus secreting cell. The prevalence in Europe shows a huge variety with almost all studies showing a decreasing trend. During childhood the highest prevalence was from Turkey (56.6%) and the lowest was from Czech Republic (4.8%). Among adults, the overall prevalence was found to be between 18.3% (Denmark) and 82.5% (Turkey), with substantial country-to-country variations. The prevalence rate differs by socioeconomic lifestyle characteristics and also genomic structure; it is also higher in less developed countries/populations. While the more commonly used test to determine H. pylori infection is serology, immunoglobulin G by enzyme-linked immunosorbent assay, the urea breath test (UBT), and stool antigen testing are non- invasive tests which are also recommended.