The Durham Initiative for Stomach Health (DISH): a pilot community-based Helicobacter pylori education and screening study

BMC Gastroenterol. 2020 Aug 6;20(1):261. doi: 10.1186/s12876-020-01405-w.

Abstract

Background: Approximately 15% of all cancers are due to infection. The bacteria Helicobacter pylori is the single leading carcinogenic infectious agent and the main cause of stomach cancer. Prevalence of H. pylori, and, correspondingly, stomach cancer incidence and mortality, is significantly greater among African Americans than whites in the United States. In the present study, we conducted a pilot community-engaged H. pylori education and screening study in partnership with a predominantly African American church in Durham, North Carolina.

Methods: Initially, we consulted with community advisory boards and convened stakeholder meetings with local community members and primary care physicians. We then developed this pilot study through an iterative collaboration with church partners. Our main outcomes were feasibility and acceptability as measured by participation in a one-day H. pylori screening initiative, and participation in follow-up for those who tested positive. We also sought to determine prevalence and determinants of active H. pylori infection in this population.

Results: Community engagement informed the event logistics, messaging, educational materials provided, and follow-up plans. A total of 92 individuals participated in the primary study event, 25% of whom had a current H. pylori infection. Of those, 87% returned for the follow-up events, among whom 70% had successfully cleared their infection.

Conclusions: Through community engagement, community-based H. pylori screening and stomach cancer prevention is feasible and acceptable. This is a necessary step in order to move stomach cancer prevention forward to population-based precision H. pylori screening and eradication.

Keywords: Cancer prevention; Education; Helicobacter pylori; Screening; Stomach cancer.

MeSH terms

  • Helicobacter Infections* / diagnosis
  • Helicobacter Infections* / epidemiology
  • Helicobacter pylori*
  • Humans
  • Pilot Projects
  • Stomach Neoplasms* / diagnosis
  • Stomach Neoplasms* / epidemiology
  • Stomach Neoplasms* / prevention & control