Abstract

BackgroundMongolia has not only the second highest incidence rate but also the highest mortality rate for gastric cancer globally. In addition to gastric cancer, ulcerative disease complications are also life threatening; thus, investigating Helicobacter pylori infection and other risk factors is essential.ResultsH.pylori infection was high in tested dyspeptic patients from all parts of Mongolia, with an overall infection rate of 80.0%. Logistic regression analysis showed that H. pylori infection was associated with gastritis (odds ratio; 9.0 ([95% confidence interval 5.0–16.2]); p < 0.0001). H. pylori infection (3.3 [2.0–5.4]; p < 0.0001) and > 40 years old (1.5 [1.0–2.0]; p < 0.02) were both associated with atrophy. However, > 40 years old (3.8 [2.4–6.0]; p < 0.0001) and high salt intakes (1.6 [1.0–2.3]; p < 0.02), but not H. pylori infection, were associated with intestinal metaplasia. Excessive amount of salt usage was dramatically higher in northern and western parts of Mongolia, where precancerous diseases, such as erosive esophagitis (for cardia cancer), severe atrophy, and intestinal metaplasia (for non-cardia cancer), were highly prevalent.ConclusionsH. pylori infection was the major gastric health problem among the Mongolian population. In addition, environmental factors such as high salt intake worsened the clinical outcome. Therefore, a nationwide screening and eradication of H. pylori infection as well as salt-reducing measures should be implemented.

Highlights

  • Mongolia has the second highest incidence rate and the highest mortality rate for gastric cancer globally

  • Gastric atrophy and intestinal metaplasia (IM) are considered as the precursor disease for non-cardia gastric cancer (GC) [21] while GERD is considered as precursor disease for cardia GC [22]

  • We found that H. pylori infection was associated with precursor GC diseases and ulcerative diseases among Mongolian patients

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Summary

Introduction

Mongolia has the second highest incidence rate and the highest mortality rate for gastric cancer globally. In addition to gastric cancer, ulcerative disease complications are life threatening; investigating Helicobacter pylori infection and other risk factors is essential. Mongolia has the second highest incidence of gastric cancer (GC) worldwide [1]. A current global systematic review showed that H. pylori infection continues to be a major public health issue worldwide, and approximately 4.4 billion individuals were estimated to be infected [10]. The prevalence of H. pylori infection varies geographically, based on ethnicity, age, socioeconomic factors, and is more frequent in developing than developed countries [11]. The infection is usually acquired in early childhood and reaches 80–100% during adolescence in developing countries [8] probably due to oral–oral, fecal–oral [14], or gastro–oral transmission [15]

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