ReviewsGastric cancer in sub-Saharan AfricaSegal, I1; Ally, R1; Mitchell, H2Author Information 1African Institute of Digestive Diseases, Chris Hani Baragwanath Hospital, PO Bertsham, 2013 Soweto, Johannesburg, South Africa. 2The School of Microbiology and Immunology, University of New South Wales, Sydney, Australia. Correspondence to: I Segal. Fax: (+27) 11 933 8921. Received 24 May 2001 Accepted 16 July 2001 European Journal of Cancer Prevention: December 2001 - Volume 10 - Issue 6 - p 479-482 Buy Abstract Gastric cancer has a variable but generally low prevalence in black populations of sub-Saharan Africa, despite a high prevalence of Helicobacter pylori (the ‘African enigma’). Evidence from Soweto indicates that the host response to H. pylori may be protective against a virulent organism and that, in most people, H. pylori does not lead to more serious sequelae. This suggests that there may be host protective/inhibitory factors present, which prevent the progression of H. pylori-induced chronic active gastritis to cancer. © 2001 Lippincott Williams & Wilkins, Inc.