The North American medical community is changing the way it treats a stomach bacteria with the potential to cause cancer thanks, in part, to residents of Aklavik.
After a study of 376 people in Aklavik, along with participants from Fort McPherson, Tuktoyaktuk and Old Crow, Yukon, researchers have changed the types and duration of antibiotics courses they prescribe for Helicobacter pylori.
Commonly known as H. Pylori, the bacteria can cause pain, upset stomachs, and in rarer cases, stomach ulcers in about 10 per cent of people infected and stomach cancer in about 1 per cent or less.
The bacteria, which lives in the stomach, can last for a long time and is estimated to affect about half of the world’s population.
In the North however, rates of H. pylori infection are disproportionately high.
A decade ago, then-mayor of Aklavik Billy Archie decided to look into why so many people in his community were getting sick.
“(When) you live in a small community, it’s so obvious when someone passes on, and it’s just a lot of that stomach cancer,” Archie said Thursday.
The study, he said, “went well, right from the beginning. There was such a positive response from the community.”
Archie helped bring Aklavik’s health concerns to the attention of University of Alberta researchers, who launched the CANHelp working group to better understand H. pylori in the Northwest Territories and northern Yukon.
Researchers did a breath test on 333 participants in Aklavik. 58 per cent of them tested positive for H. pylori infection.
Of the Aklavik participants who agreed to further testing, including a biopsy, 91 per cent were found to have “moderate or severe inflammation of the stomach,” according to a 2015 CANHelp report.
“This frequency of moderate to severe chronic inflammation is consistent with an increased risk of stomach cancer in this community,” reads the report.
Janice Geary, managing director of the CANHelp working group, said that in the four Beaufort Delta communities studied, the rate of infection ranged from 57 to 66 per cent.
Estimates for most regions of southern Canada put infection rates at between five and 30 per cent.
Geary said scientists believe there was a time when all humans had H. pylori.
“The question is,” she said, “Why did it go down in some regions and not in others?”
Scientists still don’t fully understand why H. pylori rates are lower in the south than in the north.
Most people contract H. pylori as children.
The bacteria is released with “rapid evacuation” of the stomach—vomiting or diarrhea— and children are more susceptible because they are sick more often and haven’t developed good hygiene practices.
Researchers also found that Beaufort Delta residents infected with the bacteria had greater inflammation in their guts than people with H. pylori elsewhere in the country.
Residents were worried that fish they were eating had exposed them to mercury, and that had something to do with the inflammation. These concerns led to a separate health study.
“Mercury isn’t going to impact whether or not a person gets H. pylori, but it could have impacts on whether or not someone develops disease in their stomach,” said Geary.
The mercury study found that nobody had levels close to what would be worrisome, she said.
It is still unclear why inflammation is more common in Northern residents.
Evidence from the CANHelp study revealed that previously prescribed treatments weren’t that effective.
In 2013, using information from Aklavik and Old Crow, health authorities in the Beaufort Delta changed how they recommend treating H. pylori.
The research also informed clinical guidelines on H. pylori that were published across Canada last year. The community projects, said Geary, have influenced treatment of the infection in Canada and the United States.
Geary said Aklavik residents can feel proud that their participation has made a difference in how H. pylori is treated.
“Everything that we have produced has been because of the exceptional guidance by communities and participation by individuals in the research itself,” she said.
Now, “over 90 per cent of the time, a person who takes all the medications will be cleared of the infection,” said Geary.
“It’s a much higher proportion of people who have a successful treatment when they’re using the new therapy.”
Testing for H. pylori is complete and the CANHelp working group is now disseminating the results of its research back to the communities.
Today, said Archie, there is more awareness of the infection.
“People looking after themselves better and trying to reduce cancer and learning more about it,” he said.