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      Age-related twin-peak prevalence profiles of H. pylori infection, gastritis, GIN and gastric cancer: Analyses of 70,534 patients with gastroscopic biopsies

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          Abstract

          Objectives

          H. pylori (Hp) infection has been indicated in the pathogenesis of gastric diseases including gastric cancer (GC). This study aimed at exploring the relationships between Hp infection and gastric diseases including GC in a large dataset of routine patients undergoing gastroscopy.

          Methods

          From November 2007 to December 2017, 70,534 first-time visiting patients aged 18–94 years with gastroscopic biopsies were histologically diagnosed and analyzed. Patients’ data were entered twice in an Excel spreadsheet database and analyzed using the SPSS (version 22.0) software package and statistical significance was defined as P<0.05 for all analyses.

          Results

          The first interesting observation was age-related twin-peak prevalence profiles (TPPs) for Hp infection, gastritis, and advanced diseases with different time spans (TS) between the first and second occurring peaks. Hp infection and gastritis had TPPs occurring at earlier ages than TPPs of gastric introepithelial neoplasia (GIN) and GC. More patients were clustered at the second occurring TPPs. The time spans (TS) from the first occurring peak of Hp infection to the first occurring peaks of other gastric diseases varied dramatically with 0–5 years for gastritis; 5–15 years for GINs, and 5–20 years for GC, respectively. The number of males with Hp infection and gastric diseases, excluding non-atrophic gastritis (NAG), was more than that of females (P<0.001).

          Conclusions

          We have first observed age-related twin-peak prevalence profiles for Hp infection, gastritis, GIN, and GC, respectively, among a large population of patients undergoing gastroscopy. The second prevalence peak of GC is at ages of 70–74 years indicating that many GC patients would be missed during screening because the cut-off age for screening is 69 years old in China.

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          Most cited references28

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          Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

          This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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            With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Because of China's massive population (1.37 billion), previous national incidence and mortality estimates have been limited to small samples of the population using data from the 1990s or based on a specific year. With high-quality data from an additional number of population-based registries now available through the National Central Cancer Registry of China, the authors analyzed data from 72 local, population-based cancer registries (2009-2011), representing 6.5% of the population, to estimate the number of new cases and cancer deaths for 2015. Data from 22 registries were used for trend analyses (2000-2011). The results indicated that an estimated 4292,000 new cancer cases and 2814,000 cancer deaths would occur in China in 2015, with lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death. Residents of rural areas had significantly higher age-standardized (Segi population) incidence and mortality rates for all cancers combined than urban residents (213.6 per 100,000 vs 191.5 per 100,000 for incidence; 149.0 per 100,000 vs 109.5 per 100,000 for mortality, respectively). For all cancers combined, the incidence rates were stable during 2000 through 2011 for males (+0.2% per year; P = .1), whereas they increased significantly (+2.2% per year; P < .05) among females. In contrast, the mortality rates since 2006 have decreased significantly for both males (-1.4% per year; P < .05) and females (-1.1% per year; P < .05). Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.
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              Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries

              In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival as a metric of the effectiveness of health systems and to inform global policy on cancer control. CONCORD-3 updates the worldwide surveillance of cancer survival to 2014.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: MethodologyRole: Project administrationRole: SoftwareRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: MethodologyRole: Project administrationRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: Validation
                Role: Data curationRole: InvestigationRole: MethodologyRole: SoftwareRole: Validation
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: Methodology
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Investigation
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisition
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisition
                Role: MethodologyRole: Project administrationRole: SoftwareRole: Validation
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: Methodology
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: ResourcesRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                21 July 2022
                2022
                : 17
                : 7
                : e0265885
                Affiliations
                [1 ] Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China
                [2 ] The Key Laboratory for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China
                [3 ] Department of Gastroenterology, Jinling Hospital, Nanjing, Jiangsu, China
                [4 ] Department of Preventive Medicine, Shihezi University School of Medicine, Shihezi, Xinjiang, China
                [5 ] Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
                University of Malaya Faculty of Medicine, MALAYSIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0003-1269-2211
                Article
                PONE-D-21-21676
                10.1371/journal.pone.0265885
                9302749
                35862441
                bc8c5dbe-ab45-408b-9f7e-6f0834f75b49
                © 2022 Xu et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 9 July 2021
                : 10 March 2022
                Page count
                Figures: 2, Tables: 4, Pages: 13
                Funding
                Funded by: the ministry of science and technology of china
                Award ID: 2009BAI82B02
                Award Recipient :
                Funded by: the oasis scholar fund of shihezi university
                Award ID: (no. LZXZ201023)
                Award Recipient :
                Funded by: Corps Achievement Transfer Project
                Award ID: 2018BA006
                Funded by: CX Major Public Health Cancer Early Diagnosis and Early Treatment for Cancer Registration Project
                Award ID: 0305+KC0026
                This work was supported by grants from the Ministry of Science and Technology of China (No. 2009BAI82B02), the Corps Achievement Transfer Project (No. 2018BA006), the CX Major Public Health Cancer Early Diagnosis and Early Treatment for Cancer Registration Project (0305+KC0026) and the Oasis Scholar Fund of Shihezi University (No. LZXZ201023). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Gastroenterology and Hepatology
                Gastrointestinal Infections
                Medicine and Health Sciences
                Gastroenterology and Hepatology
                Gastritis
                Medicine and Health Sciences
                Oncology
                Cancers and Neoplasms
                Gastrointestinal Tumors
                Gastric Cancer
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Biopsy
                Biology and Life Sciences
                Microbiology
                Medical Microbiology
                Microbial Pathogens
                Bacterial Pathogens
                Helicobacter Pylori
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Pathogens
                Microbial Pathogens
                Bacterial Pathogens
                Helicobacter Pylori
                Biology and Life Sciences
                Organisms
                Bacteria
                Helicobacter
                Helicobacter Pylori
                Biology and Life Sciences
                Anatomy
                Histology
                Medicine and Health Sciences
                Anatomy
                Histology
                Medicine and Health Sciences
                Oncology
                Cancers and Neoplasms
                Carcinoma
                Adenocarcinoma
                Medicine and Health Sciences
                Oncology
                Cancers and Neoplasms
                Malignant Tumors
                Custom metadata
                The data underlying the results presented in the study are available from Dr. JM Hu and his email address is 39189926@ 123456qq.com . Our Institutional Ethical Review Committee has set ethical guidelines/restrictions on any patients’ data that contain potentially identifying and/or sensitive patient information cannot be shared with any personnel, including inside hospital personnel and outside hospital personnel who are not involved in or permitted to the study materials or patients’ data. The current study was categorized as the one covered by the above restrictions, and therefore, the patients’ data used in this study cannot be shared publically. However, readers who may be interested in the patients’ data may make inquiries to Dr. JM Hu, Chair of the Department of Pathology, Shihezi University School of Medicine, who is in charge of patients’ data accessibility and his contact Email is: 39189926@ 123456qq.com .

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