A prospective evaluation of 200 upper endoscopies performed in Alaska Native persons.
OBJECTIVE
To characterize the nature and prevalence of disease in Alaska Native patients referred for evaluation of upper gastrointestinal signs and symptoms.


METHODS
Cross-sectional.


METHODS
Two hundred consecutive Alaska Native patients referred to a statewide tertiary center were prospectively evaluated. A standardized data collection form documenting EGD findings was utilized. Routine biopsies of the antrum and fundus were taken on all patients. Additional tissue was obtained from any areas of clinical concern.


RESULTS
Among 200 patients who underwent EGD during the study period, 130 (65%) tested H. pylori-positive on histology. Among 173 patients with histologic evidence of gastritis, 114 (66%) tested H. pylori-positive on histology. Chronic gastritis (87%), gastric ulcer (GU 12%), duodenal ulcer (DU 3%) and gastric cancer (2%) were the predominant findings. The GU:DU ratio was 4:1, the inverse of that reported in the general U.S. population.


CONCLUSIONS
Alaska Native patients referred for upper endoscopy have a high rate of H. pylori infection with predominantly gastric manifestations of disease and a GU:DU ratio, which is the inverse of what is typically seen in the U.S. and other developed countries. The high prevalence of H. pylori in Alaska Native patients resembles prevalence patterns reported from developing countries and may be linked to a rate of gastric cancer that is over three times that found in the U.S. population at large.
Sacco
Frank
F
Department of Surgery, Alaska Native Medical Center, Anchorage 99508, USA. fsacco@anmc.org
Bruce
Michael G
MG
McMahon
Brian J
BJ
Bruden
Dana
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000413:Alaska / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004381:Duodenal Ulcer / Q000175:diagnosis / Q000208:ethnology; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data; D005260:Female; D005756:Gastritis / Q000175:diagnosis / Q000208:ethnology; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000208:ethnology* / Q000473:pathology; D016481:Helicobacter Infections / Q000175:diagnosis / Q000208:ethnology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D004930:Inuit / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000208:ethnology; D013276:Stomach Ulcer / Q000175:diagnosis / Q000208:ethnology; D041742:Upper Gastrointestinal Tract / Q000473:pathology*