ABSTRACT Infection with Helicobacter pylori is the strongest modifiable risk factor for stomach cancer. Nine out of 10 people who develop stomach cancer in the distal part of the stomach have been infected with H. pylori. Infection of the gastric mucosa with H. pylori most commonly occurs during childhood and if not treated can cause chronic inflammation and gastric carcinogenesis. Stomach cancer is a major contributor to the ethnic gap in cancer incidence and mortality in New Zealand, with Māori and Pacific peoples having three to six times higher rates of stomach cancer than New Zealand Europeans. Infection with H. pylori is the main driver of this inequity. Testing asymptomatic individuals with non-invasive tests (serology, stool or C-urea breath tests), and treating those who are infected with H. pylori using antibiotics and proton pump inhibitors has been found to be effective in reducing stomach cancer incidence, with an estimated one-third reduction in risk. A programme based on this approach is likely to be cost-effective in New Zealand, and pro-equity particularly if targeted towards Māori and Pacific peoples. However, there are substantial gaps in our knowledge base that must be filled before such a programme can be considered.

中文翻译：

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新西兰幽门螺杆菌、胃癌及其预防

摘要 幽门螺杆菌感染是胃癌最强的可改变危险因素。10 个在胃远端发展为胃癌的人中有 9 个感染了幽门螺杆菌。胃粘膜感染幽门螺杆菌最常发生在儿童时期，如果不治疗，会导致慢性炎症和胃癌发生。胃癌是造成新西兰癌症发病率和死亡率种族差异的主要原因，毛利人和太平洋人的胃癌发病率是新西兰欧洲人的三到六倍。感染幽门螺杆菌是造成这种不平等的主要因素。使用非侵入性测试（血清学、粪便或 C-尿素呼气测试）检测无症状个体，并治疗感染幽门螺杆菌的个体。已发现使用抗生素和质子泵抑制剂的幽门螺杆菌可有效降低胃癌发病率，估计风险降低三分之一。基于这种方法的计划在新西兰可能具有成本效益，并且有利于公平，特别是如果针对毛利人和太平洋地区人民。但是，我们的知识库中存在大量空白，必须先填补这些空白，然后才能考虑此类计划。