An age- and gender-specific analysis of H. Pylori infection

The objective of this study was to determine the incidence of Helicobacter pylori infection in different age and sex groups from the southern region of Saudi Arabia, and to relate the results to the high incidence of gastric cancer in this region. The carcinogenic effect of H. pylori is considered to be age-dependent. H. pylori infection early in life predisposes patients to gastric cancer. In contrast, acquisition of infection later in life leads to development of duodenal ulcer. We studied 528 consecutive endoscopic biopsies over a period from March 1995 to August 1996. The presence or absence of H. pylori was tabulated according to age and sex of the patients. Three hundred and fifty-three (67%) of 528 patients were positive for H. pylori. There were 313 males, among whom 217 (69%) were positive. There were 215 females, among whom 136 (63%) were positive for H. pylori. The presence of H. pylori in various age groups was as follows: under 16 years, 62%; 16 to 25 years, 67%; 26-35 years, 69%; 36-45 years, 67%; 46-55 years, 66%; and 56 years and above, 65%. Statistical analysis revealed no significant difference between the groups. No significant rise in the infection rate was noted from childhood to advanced age. These data support the belief that H. pylori infection was acquired early in life, leading to multifocal gastritis and thus predisposing the patients to gastric cancer later in life. However, H. pylori may not be the single agent of gastric cancer inasmuch as the infection affects both genders equally, whereas gastric cancer has a male preference. Perhaps some additional factors augment the pivotal role of H. pylori.