title: Helicobacter pylori infection appears essential for stomach carcinogenesis: observations in Semarang, Indonesia.
abstract: The gastric cancer incidence in Semarang, Indonesia, is exceedingly low: only approximately 1/100th of the level in Japan. To elucidate the reason, we carried out an ecological study recruiting 69 male and 102 female participants from the general populace in January 2005. Positive urea breath tests were 0% for both men and women, and Helicobacter pylori (H. pylori) IgG antibodies were found in 2% (0-5, 95% confidence interval) of men and 2% (0-4) of women, significantly lower than the 62% (58-65) and 57% (53-60), respectively, in Japan. Furthermore, there were no positive findings with the pepsinogen tests in Semarang, again significant in comparison with the 23% (22-25) and 22% (20-23) in Japan. Variation in smoking levels and consumption of NaCl, vegetables and fruit were found, but not to an extent that would allow explanation of the major differences in gastric cancer incidence. We may conclude that the very low prevalence of H. pylori infection and thus chronic atrophic gastritis account for the rarity of stomach cancer in Semarang, Indonesia.
authors.affiliation: Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya 467-8601, Japan. tokudome@med.nagoya-cu.ca.jp
authors.forename: Shinkan
authors.initials: S
authors.lastname: Tokudome
authors.forename: Witjitra D
authors.initials: WD
authors.lastname: Samsuria Soeripto
authors.forename: F X Ediati
authors.initials: FX
authors.lastname: Triningsih
authors.forename: Sadao
authors.initials: S
authors.lastname: Suzuki
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hosono
authors.forename: Teguh
authors.initials: T
authors.lastname: Triono
authors.forename: Indra Wijaya
authors.initials: IW
authors.lastname: Sarjadi
authors.forename: Ika P
authors.initials: IP
authors.lastname: Miranti
authors.forename: Reza
authors.initials: R
authors.lastname: Ghadimi
authors.forename: Malcolm A
authors.initials: MA
authors.lastname: Moore
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D001944:Breath Tests; D004032:Diet; D005260:Female; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D015994:Incidence; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D012907:Smoking; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000382:microbiology*
chemical_list: D000907:Antibodies, Bacterial