Abstract
BackgroundApproximately 15% of all cancers are due to infection. The bacteria Helicobacter pylori is the single leading carcinogenic infectious agent and the main cause of stomach cancer. Prevalence of H. pylori, and, correspondingly, stomach cancer incidence and mortality, is significantly greater among African Americans than whites in the United States. In the present study, we conducted a pilot community-engaged H. pylori education and screening study in partnership with a predominantly African American church in Durham, North Carolina.MethodsInitially, we consulted with community advisory boards and convened stakeholder meetings with local community members and primary care physicians. We then developed this pilot study through an iterative collaboration with church partners. Our main outcomes were feasibility and acceptability as measured by participation in a one-day H. pylori screening initiative, and participation in follow-up for those who tested positive. We also sought to determine prevalence and determinants of active H. pylori infection in this population.ResultsCommunity engagement informed the event logistics, messaging, educational materials provided, and follow-up plans. A total of 92 individuals participated in the primary study event, 25% of whom had a current H. pylori infection. Of those, 87% returned for the follow-up events, among whom 70% had successfully cleared their infection.ConclusionsThrough community engagement, community-based H. pylori screening and stomach cancer prevention is feasible and acceptable. This is a necessary step in order to move stomach cancer prevention forward to population-based precision H. pylori screening and eradication.
Highlights
15% of all cancers are due to infection
Stomach cancer accounts for the greatest difference in death rates between African American men and women, compared to non-Hispanic white men and women [1]
30% of Americans are chronically infected with H. pylori, with rates above 50% for men and women of color, including African Americans, Asian Americans, and Hispanics [2, 3]
Summary
The bacteria Helicobacter pylori is the single leading carcinogenic infectious agent and the main cause of stomach cancer. Prevalence of H. pylori, and, correspondingly, stomach cancer incidence and mortality, is significantly greater among African Americans than whites in the United States. Infection with the bacteria Helicobacter pylori (H. pylori) is the primary cause of stomach cancer, the 6th leading cause of death from cancer among African American men. Stomach cancer accounts for the greatest difference in death rates between African American men and women, compared to non-Hispanic white men and women [1]. There is no systematic H. pylori screening and eradication plan in the United States to prevent stomach cancer or other H. pylori-associated diseases (gastritis, peptic ulcers, and MALT lymphoma), even though H. pylori eradication therapy has been shown to be highly effective and feasible [4]. Population-wide screening and treatment for H. pylori has been estimated to be substantially cost-effective, even in lower-risk countries like the United States [6, 7]
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