Clinical and Epidemiological Data on Inflammatory Bowel Disease, Colorectal Cancer and Helicobacter Pylori infection in Turkey

Abstract

SUMMARY
Turkey is a bridge between east and west and a midway for
many emigrations. Although there is no big ethnical groups
in this country,there is a great variation in culture, living
conditions, dietary habits, environment, access to medical
care. These factors topped by different socioeconomical
conditions and genetic background lead to different epidemiology
of certain diseases throughout the country. Improving
hygienic conditions and socioeconomical level made the
seroprevalence of Helicobacter pylori infection to decrease
from 78.5% to 66.4 over the past ten years. Similar to the
western epidemiological data Hp tends to affect less the
young age group as compared to adults. On the other hand
increasing resistance to antimicrobials used to eradicate
the bacterium will obviate the need for more powerful and
effective regimens in the near future. Inflammatory bowel
diseases are frequently encountered in Turkey Its incidence
is less than North and West Europe but close to Middle
East. (4.4/100.000 for UC and 2.2/100.000 for CD). The disease
affects both sexes to the same degree. Distal Colitis in
UC and ileocolitis in CD are more frequent than other localizations.
Amebiasis occurs in about 1/3 of cases in UC
and 10 % of cases with CD. This parasite is observed as a
concomitant infestation with IBD or as a trigger for flare
up in both conditions. Colorectal cancer is the second most common GI malignancy after gastric cancer in Turkey. The
distribution of colorectal cancer shows variations from west
to east.Whilst esophageal and gastric cancers are more prevalent
in the east, colon cancer is relatively more common in
western parts of Anatolia. Males and females seem to be
affected to the same degree and the 5th and 6th decades are
the more frequent ages of involvement. Although some studies
reported a trend towards right sided involvement in colon
cancer, rectum and sigmoid are still the sites of predilection
for colon cancer. Many environmental and genetic
factors play a role in the development of colon cancer but
the existing small studies discussing the contribution of
some etiological factors such as dietary habits, vitamin and
mineral deficiencies, environment etc. have to be validated
in larger,controlled trials. The common denominator of all
three conditions is their strong link with some socioeconomical
parameters, the threat of environmental factors,
their changing incidence over the past decades and their
malignant or potential malignant character which affects
their prognosis. Whether it be infectious or non infectious
the best would be to bring together all the existing information
and to unite forces in such a direction that these disorders
could be prevented or completely eradicated from the
region.