Changing trends in the prevalence of H. pylori infection in Japan (1908–2003): a systematic review and meta-regression analysis of 170,752 individuals

Wang, Chaochen; Nishiyama, Takeshi; Kikuchi, Shogo; Inoue, Manami; Sawada, Norie; Tsugane, Shoichiro; Lin, Yingsong

doi:10.1038/s41598-017-15490-7

Cited by 76 publications

(103 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A meta‐analysis involving 170 752 Japanese inhabitants showed that the prevalence of H. pylori decreased steadily in those born from 1948 to 2003, with a predicted prevalence of infection of 60.9% in those born in 1910 and 6.6% in those born in 2000. In individuals born after 1998, H. pylori prevalence was lower than 10% …”

Section: Global Prevalence Of Helicobacter Pylori Infectionmentioning

confidence: 90%

“…In individuals born after 1998, H. pylori prevalence was lower than 10%. 20 A hospital-based study in southwest China that investigated H. pylori infection in 10 912 subjects by urea breath test (UBT) reported a prevalence of 34.4%, 21 whereas a multicentre, nationwide prospective study enrolling 4734 asymptomatic Korean adults in seven geographic areas 22 showed a seropositivity in 51.0% of the cases. A higher H. pylori prevalence (80.0%) was found among Mongolian dyspeptic patients.…”

Section: Asiamentioning

confidence: 99%

See 1 more Smart Citation

Epidemiology of Helicobacter pylori infection

et al. 2018

View full text Add to dashboard Cite

This review provides the most recent data concerning the epidemiology of Helicobacter pylori infection. Overall, the trend of declining prevalence of H. pylori infection is continuing, with major evidence available from studies in Europe. However, in some parts of the world, for example, in some countries in the Middle East, the prevalence has remained relatively stable. A number of systematic reviews and meta-analyses have been published during the past year indicating the lowest prevalence rates of the infection in Oceania (24.4%), the highest in Africa (79.1%), and the global annual recurrence rate of H. pylori (4.3%). The recurrence rates were found to be directly related to the human development index and prevalence of infection. Several studies have addressed the correlation between H. pylori infection and sociodemographic conditions, source of drinking water and dietary factors. A hypothesis on the role of insects and yeasts in transmitting H. pylori has been suggested and addressed. Helicobacter sp. have been found in flow flies in Brazil. So far there is no evidence available that H. pylori may survive and persist on the outer body of the fly.

show abstract

Section: Global Prevalence Of Helicobacter Pylori Infectionmentioning

confidence: 90%

Section: Asiamentioning

confidence: 99%

Epidemiology of Helicobacter pylori infection

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The changing prevalence of H. pylori infection in the general population over time is considered as the main cause for the declining GC mortality in Japan. In a systematic review with meta‐regression analysis, Wang et al reported the prevalence of H. pylori infection among 170 752 Japanese individuals. The predicted prevalence of H. pylori infection was 60.9% (95% CI 56.3‐65.4), 64.1% (95% CI 63.1‐65.1), 34.9% (95% CI 34.0‐35.8), and 6.6% (95% CI 4.8‐8.9) among those who were born in the year 1910, 1940, 1970, and 2000, respectively.…”

Section: Gastric Cancer: Epidemiological Aspectsmentioning

confidence: 99%

Gastric cancer: epidemiology, prevention, and therapy

et al. 2018

View full text Add to dashboard Cite

Gastric cancer (GC) is still the third leading cause of cancer death in both sexes worldwide. Helicobacter pylori infection is the most important risk factor for GC and, in spite of the consistent trend of a decreasing incidence, in 2015 approximately 4.4 billion individuals-more than half the world's population-were infected with H. pylori. The birth cohort pattern of decreased H. pylori infection reported in a systematic review contributes to explain the declining GC mortality in Japan. Current trends in estimated annual percentage change of GC incidence foreshadow expected reversals in both falling incidence and male predominance among US non-Hispanic whites. Combining serum pepsinogen 1 and H. pylori serology was shown to be useful for GC risk stratification in a Finnish population. Gastritis staging by operative link on gastritis assessment was confirmed to be reliable in predicting GC risk in a large prospective study. In a randomized trial from South Korea, H. pylori eradication therapy significantly reduced the rates of metachronous GC in patients who received curative endoscopic resection for early GC. A study based on a territory-wide health care database of the Hong Kong Hospital Authority showed that aspirin use is associated with a reduced GC risk. Another study based on the same database showed that proton pump inhibitors increase GC risk, but methodological biases have most likely acted as confounders. Confirmatory data on the role of endoscopic submucosal dissection in patients with early GC have been published. The phase III FLOT4 trial has shown that the FLOT triplet regimen (docetaxel, oxaliplatin, leucovorin, and 5-fluorouracil) improves the outcome of patients with GC and locoregional disease as compared to the ECF triplet (epirubicin, cisplatin, and 5-fluorouracil). In the phase III ATTRACTION-2 trial, nivolumab was shown to be an effective treatment option with a relative safe profile for heavily pretreated patients with advanced GC.

show abstract

“…First, as mentioned above, the use of metronidazole is restricted, and it has not yet been approved for H pylori eradication therapy among children and adolescents. Because the prevalence of H pylori infection is as low as 3%‐5% among Japanese children and adolescents, we would not expect a drastic increase in use of metronidazole for H pylori eradication among infected individuals, even if we were able to implement a universal “test‐and‐treat” protocol for all Japanese children and adolescents. Second, acquired resistance to metronidazole among anaerobic bacteria remains rare, despite extensive worldwide use over the past several decades .…”

Section: Discussionmentioning

confidence: 99%

“…The situation regarding H pylori infection in the general Japanese population has changed dramatically over the past several decades; the prevalence of H pylori infection is rapidly decreasing in all age groups, with a clear birth-cohort effect underlying this declining trend. 6 Although it remains unclear whether eradication therapy for H pylori in young adulthood leads to a decreased risk of gastric cancer, it improves chronic gastritis and confers benefits such as reducing the risk of developing or experiencing a recurrence of H pylori-related diseases, including peptic ulcers, iron deficiency anemia, and idiopathic thrombocytopenic purpura. 3 Due to these benefits and the potential gastric cancer prevention effects, an increasing number of local government-initiated gastric cancer prevention programs, which involve population-wide testing and eradication among children and adolescents, have been initiated in Japan.…”

mentioning

confidence: 99%

Metronidazole for Helicobacter pylori eradication therapy among children and adolescents in Japan: Overcoming controversies and concerns

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background Metronidazole is an antiprotozoal drug used to treat a broad spectrum of infectious diseases, including Helicobacter pylori (H pylori) infections. In Japan, metronidazole is approved for the eradication therapy of H pylori as a second‐line regimen among adults, but it has not yet been approved for use among children and adolescents. Materials and Methods To perform this narrative review, we searched the relevant literature on important events in the history of the use of metronidazole, its mechanisms of action, its efficacy, and the adverse effects reported in clinical trials or cohort studies in Japan. Results At present, metronidazole resistance has not been a serious issue in Japan in large part due to its restricted use. Emerging evidence from randomized controlled trials demonstrates higher eradication rates for metronidazole than for clarithromycin, supporting its use in both first‐line and second‐line eradication therapies. Among the reported adverse effects, there has been lingering concern over the potential carcinogenicity of metronidazole in humans. However, the possibility of an increased cancer risk is not limited to metronidazole; the long‐term use of antibiotics has been linked to increased risk for some site‐specific cancers. However, recent prospective studies have suggested that short‐term exposure to antibiotics is not associated with an increased cancer risk. Conclusion Sensible use of metronidazole backed by research evidence could maximize the benefits associated with H pylori eradication in Japan.

show abstract

Changing trends in the prevalence of H. pylori infection in Japan (1908–2003): a systematic review and meta-regression analysis of 170,752 individuals

Cited by 76 publications

References 66 publications

Epidemiology of Helicobacter pylori infection

Epidemiology of Helicobacter pylori infection

Gastric cancer: epidemiology, prevention, and therapy

Metronidazole for Helicobacter pylori eradication therapy among children and adolescents in Japan: Overcoming controversies and concerns

Contact Info

Product

Resources

About