https://scholars.lib.ntu.edu.tw/handle/123456789/545373
標題: | Planning mass eradication of Helicobacter pylori infection for indigenous Taiwanese peoples to reduce gastric cancer | 作者: | Bair M.-J. Chuang S.-L. Lei W.-Y. Chen C.-L. Tian H.-W. TSUNG-HSIEN CHIANG Su W.W.-Y. Lin C.-C. Chung Lo Y.-T. Jou Y.-Y. Wu C.-Y. Chia S.-L. MING-SHIANG WU Chen, Tony Hsiu Hsi Chu C.-H. YI-CHIA LEE Wang Y.-W. |
公開日期: | 2020 | 出版社: | Blackwell Publishing | 卷: | 35 | 期: | 4 | 起(迄)頁: | 609-616 | 來源出版物: | Journal of Gastroenterology and Hepatology (Australia) | 摘要: | Background and Aim: The aim of this study is to identify gastric cancer burden in Indigenous Taiwanese peoples and conduct a project to evaluate how to reduce the disparities most effectively in Indigenous communities. Methods: First, we quantified the health disparities in gastric cancer in Indigenous peoples using data from the cancer registries during the period of 2006–2014. Second, we identified parameters that might be associated with Helicobacter pylori infection or help identify a good eradication strategy. Results: Gastric cancer incidence (24.4 vs 12.3 per 100?000 person-years) and mortality rates (15.8 vs 6.8 per 100?000 person-years) were higher in Indigenous than in non-Indigenous, with 2.19-fold (95% confidence interval [CI]: 2.06–2.33) and 2.47-fold (2.28–2.67) increased risk, respectively. In Indigenous communities, H.?pylori infection was more prevalent in Indigenous than in non-Indigenous (59.4% vs 31.5%, P?0.01). Regression analyses consistently showed that either the mountain or plain Indigenous had 1.89-fold (95% CI: 1.34–2.66) and 1.73-fold (95% CI: 1.24–2.41) increased risk for H.?pylori infection, respectively, as compared with non-Indigenous, adjusting for other baseline characteristics. The high infection rates were similarly seen in young, middle-aged, and older adults. Program eradication rates using clarithromycin-based triple therapy were suboptimal (73.7%, 95% CI: 70.0–77.4%); the habits of smoking (1.70-fold, 95% CI: 1.01–2.39) and betel nut chewing (1.54-fold, 95% CI: 0.93–2.16) were associated with the higher risk of treatment failure. Conclusion: Gastric cancer burden is higher in Indigenous Taiwanese peoples than in their non-Indigenous counterparts. Eliminating the prevalent risk factor of H.?pylori infection is a top priority to reduce this health disparity. ? 2019 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85076150714&doi=10.1111%2fjgh.14898&partnerID=40&md5=ac4cb28f85dec5e9245d0c1e53f3b473 https://scholars.lib.ntu.edu.tw/handle/123456789/545373 |
ISSN: | 0815-9319 | DOI: | 10.1111/jgh.14898 | SDG/關鍵字: | amoxicillin; clarithromycin; lansoprazole; levofloxacin; urea c 13; clarithromycin; Article; Austronesian people; betel nut chewing; cancer incidence; cancer mortality; cancer prevention; cancer registry; controlled study; disease eradication; female; health disparity; Helicobacter infection; human; indigenous people; infection rate; limit of quantitation; male; mastication; mortality rate; multiple cancer; priority journal; retreatment; smoking; stomach cancer; Taiwanese; treatment failure; tumor volume; urea breath test; adverse event; Areca; combination drug therapy; complication; cost of illness; gastritis; health care disparity; Helicobacter infection; Helicobacter pylori; incidence; microbiology; mortality; prevalence; risk factor; stomach tumor; Taiwan; Areca; Clarithromycin; Cost of Illness; Drug Therapy, Combination; Gastritis; Healthcare Disparities; Helicobacter Infections; Helicobacter pylori; Incidence; Indigenous Peoples; Prevalence; Risk Factors; Smoking; Stomach Neoplasms; Taiwan |
顯示於: | 醫學系 |
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