<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1659-0201</journal-id>
<journal-title><![CDATA[Población y Salud en Mesoamérica]]></journal-title>
<abbrev-journal-title><![CDATA[PSM]]></abbrev-journal-title>
<issn>1659-0201</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Costa Rica. Centro Centroamericano de Población]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1659-02012022000100619</article-id>
<article-id pub-id-type="doi">10.15517/psm.v0i19.49405</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Helicobacter pylori infection and serum pepsinogen concentrations in an elderly population representative of Costa Rica]]></article-title>
<article-title xml:lang="es"><![CDATA[Infección por helicobacter pylori y concentraciones séricas de pepsinógenos en una población representativa de adultos de Costa Rica]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Une]]></surname>
<given-names><![CDATA[Clas]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Malespín Bendaña]]></surname>
<given-names><![CDATA[Wendy]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez-Mayorga]]></surname>
<given-names><![CDATA[Vanessa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rosero-Bixby]]></surname>
<given-names><![CDATA[Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sierra Ramos]]></surname>
<given-names><![CDATA[Rafaela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,University of Costa Rica  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,University of Costa Rica  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,University of Costa Rica  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,University of Costa Rica  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,University of Costa Rica  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2022</year>
</pub-date>
<volume>19</volume>
<numero>2</numero>
<fpage>619</fpage>
<lpage>634</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S1659-02012022000100619&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S1659-02012022000100619&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S1659-02012022000100619&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Introduction: Costa Rica has among the highest mortality rates from gastric cancer in the world, largely due to late detection. It is therefore important that economically and logistically sustainable screening is implemented in order to detect risk of developing cancer. We have previously shown that low pepsinogen (PG) values and infection with Helicobacter pylori-CagA+ are associated with risk of gastric atrophy and cancer in Costa Rican populations. OBJECTIVES: To determine how markers for gastric cancer risk are distributed in an elderly population representative of Costa Rica in order to design a screening strategy. METHODS: The population studied consists of 2,652 participants in a nationally representative survey of ageing. Information concerning epidemiologic, demographic, nutritional and life style factors is available. Serum PG concentrations as well as H. pylori and CagA status were determined by serology. Possible associations were determined by regression analyses. RESULTS: Antibodies to H. pylori were present in 72% of the population and of those, 58% were CagA positive. Infection with H. pylori was associated with higher PGI concentrations (p=0.000) and infection with H. pylori-CagA. with lower PGI concentrations (p=0.025). Both showed association with lower PGI/PGII (p=0.006 and p=0.000). Higher age was associated with lower prevalence of H. pylori infection (OR=0.98; p=0.000) and CagA. (OR=0.98; p=0.000) but not with PG values. Regions with high risk of gastric cancer showed lower PGI (p=0.004) and PGI/PGII values (p=0.021) as well as higher prevalence of H. pylori infection (OR=1.39; p=0.013) but not CagA.. Using cut-off values of PGI&lt;100 µg/L and PGI/PGII&lt;2.0, 2.5 and 3.0, 7-15% of the population would be considered at risk. CONCLUSIONS: H. pylorialone is not a useful marker for risk of gastric cancer. Screening using serum pepsinogen concentrations and infection with H. pylori-CagA. is feasible in the general elderly population of Costa Rica but appropriate cut-off values have to be determined based on more clinical data and follow up capacity.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Introducción: Costa Rica tiene una de las tasas de mortalidad por cáncer gástrico más altas del mundo, en gran parte debido a la detección tardía. Por lo tanto, es importante que se implemente un tamizaje económico y logísticamente sostenible para detectar el riesgo de desarrollar cáncer. En estudios anteriores demostramos, que valores bajos de pepsinógeno (PG) y la infección por Helicobacter pylori-CagA+ están asociados con el riesgo de atrofia gástrica y cáncer en poblaciones costarricenses. OBJETIVO: Determinar cómo se distribuyen los marcadores de riesgo de cáncer gástrico en una población representativa de adultos de Costa Rica para diseñar una estrategia de tamizaje. MÉTODOS: Se estudió una población representativa a nivel nacional de 2.652 adultos, que formaron parte de un estudio longitudinal sobre envejecimiento. Se dispone de información sobre factores epidemiológicos, demográficos, nutricionales y de estilo de vida. Las concentraciones séricas de PG, así como el estado de H. pylori y CagA se determinaron mediante serología. Las posibles asociaciones se determinaron mediante modelos de regresión (logística y lineal múltiple). RESULTADOS: El 72% de la población presenta anticuerpos contra H. pylori, de ellos, el 58% fueron positivos para CagA. La infección por H. pylori se asoció con altas concentraciones de PGI (p = 0,000) y la infección por H. pylori-CagA+ con bajas concentraciones de PGI (p = 0,025). Ambas pruebas mostraron asociación con una baja razón PGI/PGII (p = 0,006 y p = 0,000). El rango de mayor edad se asoció con una menor prevalencia de la infección por H. pylori (OR = 0,98; p = 0,000) y de CagA+ (OR = 0,98; p = 0,000) pero no se asoció con los valores de PG. Las regiones con alto riesgo de CG mostraron valores bajos de PGI (p = 0,004) y de PGI/PGII (p = 0,021) así como una alta prevalencia de la infección por H. pylori (OR = 1,39; p = 0,013), no así con CagA+. Utilizando valores de corte de PGI&lt;100 µg/L y de PGI/PGII &lt;2,0, 2,5 y 3,0, se consideraría en riesgo de cáncer entre 7-15% de la población. CONCLUSIONES: La infección por H. pylori, por sí sola, no es un marcador de riesgo de CG útil. Es factible realizar el tamizaje de adultos de la población general de Costa Rica, utilizando como marcadores las concentraciones séricas de pepsinógenos y la infección por H. pylori-CagA+, sin embargo, los valores de corte apropiados deben determinarse con base en una mayor cantidad de datos clínicos y la capacidad de seguimiento.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[gastric cancer]]></kwd>
<kwd lng="en"><![CDATA[atrophic gastritis]]></kwd>
<kwd lng="en"><![CDATA[pepsinogens]]></kwd>
<kwd lng="en"><![CDATA[Helicobacter pylori]]></kwd>
<kwd lng="es"><![CDATA[cáncer gástrico]]></kwd>
<kwd lng="es"><![CDATA[gastritis atrófica]]></kwd>
<kwd lng="es"><![CDATA[pepsinógenos]]></kwd>
<kwd lng="es"><![CDATA[Helicobacter pylori]]></kwd>
</kwd-group>
</article-meta>
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