Arnold et al [9] performed a literature search for studies on ga

Arnold et al. [9] performed a literature search for studies on gastric cancer incidence, mortality, and survival in indigenous populations, including indigenous Australians, Maori in New Zealand, indigenous peoples from the circumpolar region, Native Americans, Alaskan natives in the USA, and the Mapuche peoples in Chile. Fifty-seven studies were selected. They identified a higher burden of gastric cancer in most of the indigenous populations globally and a rising incidence in some of them, whereas in most parts of the world, the incidence and mortality rates

from stomach cancer have decreased in the last four decades. They considered this to be of major public health concern requiring close surveillance and further research into potential risk factors. Stewart et al. [10] have reviewed the global burden of deaths from emergency surgery. The most common cause of death was complicated peptic ulcer disease with 3.5 deaths per 100,000 population per year accounting for around 27% of the deaths from the 11 other conditions combined.

Low and middle income countries carry the majority burden of surgical MI-503 mouse emergencies and their capacity to deal with the problem is inadequate, they harbor 85% of peptic ulcer-related deaths. The authors conclude that the data will be useful for both the surgical and public health communities to plan a more adequate response. The ethnic Malays of the northeastern Malaysian peninsula have had minimal interactions with populations from the nearby Indonesian archipelago

MCE or with more recent migrants, they have a low prevalence of H. pylori infection and the incidence of gastric cancer and its precursor lesions are low. However, the population has generally poor sanitation. Lee et al. [11] have suggested that a study of this population might provide insight into answering the contentious issue on whether the absence of H. pylori infection as opposed to other confounding factors might be responsible for GERD, esophageal adenocarcinoma, and allergic illness. In an extensive review of the literature relating to Malaysia, they show that erosive esophagitis, Barrett’s esophagus, distal esophageal cancers, and childhood asthma in this relatively isolated group are of low incidence and conclude that the absence of H. pylori infection is more likely to be boon than a bane (Fig. 3). Edgren et al. [12] have authored an important article that addresses the ongoing epidemic of esophageal adenocarcinoma, a condition that arises as a complication of Barrett’s esophagus which in turn is secondary to gastroesophageal gastric acid reflux. There have been suggestions that the underlying cause of this problem is the decline in H. pylori infection. This group reviewed the data on 117,946 incident cases of esophageal adenocarcinoma in a wide number of cancer registries. They found that the increase was consistent in all the countries studied (Fig.

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