{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T08:45:31Z","timestamp":1765874731361,"version":"3.48.0"},"reference-count":48,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2013,11,6]]},"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      infection, linked to gastric cancer, is responsible for a large worldwide disease burden.\n                      <jats:italic>H pylori<\/jats:italic>\n                      prevalence and gastric cancer rates are elevated among indigenous Arctic communities, but implementation of prevention strategies is hampered by insufficient information. Some communities in northern Canada have advocated for\n                      <jats:italic>H pylori<\/jats:italic>\n                      prevention research. As a first step, community-driven research was undertaken to describe the\n                      <jats:italic>H pylori-<\/jats:italic>\n                      associated disease burden in concerned communities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Participants in this cross-sectional study completed a clinical interview and gastroscopy with gastric biopsies taken for histopathological examination in February 2008.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Study procedures were carried out at the health centre in Aklavik, Northwest Territories, Canada (population \u223c600).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All residents of Aklavik were invited to complete a clinical interview and gastroscopy; 194 (58% female participants; 91% Aboriginal; age range 10\u201380\u2005years) completed gastroscopy and had gastric biopsies taken.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>\n                      This analysis estimates the prevalence of gastric abnormalities detected by endoscopy and histopathology, and associations of demographic and clinical variables with\n                      <jats:italic>H pylori<\/jats:italic>\n                      prevalence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 194 participants with evaluable gastric biopsies, 66% were\n                      <jats:italic>H pylori-<\/jats:italic>\n                      positive on histology. Among\n                      <jats:italic>H pylori<\/jats:italic>\n                      -positive participants, prevalence was 94% for acute gastritis, 100% for chronic gastritis, 21% for gastric atrophy and 11% for intestinal metaplasia of the gastric mucosa, while chronic inflammation severity was mild in 9%, moderate in 47% and severe in 43%. In a multivariable model,\n                      <jats:italic>H pylori<\/jats:italic>\n                      prevalence was inversely associated with previous gastroscopy, previous\n                      <jats:italic>H pylori<\/jats:italic>\n                      therapy and aspirin use, and was positively associated with alcohol consumption.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In this population,\n                      <jats:italic>H pylori<\/jats:italic>\n                      -associated gastric histopathology shows a pattern compatible with elevated risk of gastric cancer. These findings demonstrate that local concern about health risks from\n                      <jats:italic>H pylori<\/jats:italic>\n                      is warranted and provide an example of how epidemiological research can address health priorities identified by communities.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2013-003689","type":"journal-article","created":{"date-parts":[[2014,1,9]],"date-time":"2014-01-09T01:03:26Z","timestamp":1389229406000},"page":"e003689","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Disease manifestations of\n                    <i>Helicobacter pylori<\/i>\n                    infection in Arctic Canada: using epidemiology to address community concerns"],"prefix":"10.1136","volume":"4","author":[{"given":"Justin","family":"Cheung","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Royal Columbian Hospital, New Westminster, British Columbia, Canada"},{"name":"Department of Medicine\/Gastroenterology Division, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen J","family":"Goodman","sequence":"additional","affiliation":[{"name":"Department of Medicine\/Gastroenterology Division, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Safwat","family":"Girgis","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Bailey","sequence":"additional","affiliation":[{"name":"Department of Medicine\/Gastroenterology Division, University of Alberta, Edmonton, Alberta, Canada"},{"name":"Royal Alexandra Hospital, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Morse","sequence":"additional","affiliation":[{"name":"Stanton Territorial Hospital, Yellowknife, Northwest Territories, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard N","family":"Fedorak","sequence":"additional","affiliation":[{"name":"Department of Medicine\/Gastroenterology Division, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0743-8713","authenticated-orcid":false,"given":"Janis","family":"Geary","sequence":"additional","affiliation":[{"name":"Department of Medicine\/Gastroenterology Division, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharine","family":"Fagan-Garcia","sequence":"additional","affiliation":[{"name":"Department of Medicine\/Gastroenterology Division, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sander Veldhuyzen","family":"van Zanten","sequence":"additional","affiliation":[{"name":"Department of Medicine\/Gastroenterology Division, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the CANHelp Working Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,1,8]]},"reference":[{"key":"2025121600412613000_4.1.e003689.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(83)92719-8"},{"key":"2025121600412613000_4.1.e003689.2","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1016\/S0140-6736(88)90929-4","article-title":"Prospective double-blind trial of duodenal ulcer relapse after eradication of Campylobacter pylori","volume":"2","author":"Marshall","year":"1988","journal-title":"Lancet"},{"key":"2025121600412613000_4.1.e003689.3","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199501000-00005"},{"key":"2025121600412613000_4.1.e003689.4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03520010077036"},{"key":"2025121600412613000_4.1.e003689.5","unstructured":"International Agency for Research on Cancer. 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