Declining trends in prevalence of Helicobacter pylori infection by birth‐year in a Japanese population

Abstract

Gastric cancer incidence and mortality have been decreasing in Japan. These decreases are likely due to a decrease in prevalence of Helicobacter pylori infection. Our aim was to characterize the trends in prevalence of H. pylori infection focused on birth‐year. We carried out a cross‐sectional study that included 4285 subjects who were born from 1926 to 1989. We defined H. pylori infection by the serum H. pylori antibody titer. Individuals having H. pylori infection and those with negative H. pylori antibody titer and positive pepsinogen test were defined as high‐risk individuals for gastric cancer. We estimated the birth‐year percent change (BPC) of the prevalence by Joinpoint regression analysis. The prevalence of H. pylori infection among the subjects born from 1927 to 1949 decreased from 54.0% to 42.0% with a BPC of −1.2%. It was followed by a rapid decline in those born between 1949 (42.0%) and 1961 (24.0%) with a BPC of −4.5%, which was followed by those born between 1961 (24.0%) and 1988 (14.0%) with a BPC of −2.1%. The proportion of high‐risk individuals for gastric cancer among the subjects born from 1927 to 1942 decreased from 62.0% to 55.0% with a BPC of −0.8%. A subsequent rapid declining trend was observed in those born between 1942 (55.0%) and 1972 (18.0%) with a BPC of −3.6%, and then it became stable. These remarkable declining trends in the prevalence of H. pylori infection by birth‐year would be useful to predict the future trend in gastric cancer incidence in Japan.

Comparative Study of a Proton Pump Inhibitor with a Histamine H₂ Receptor Antagonist in Japanese Patients with Functional Dyspepsia

“…In the present study, the results in HP-negative patients were similar to those in the total patient group, indicating that HP infection is less likely to affect the short-term effect of gastric acid suppressants on dyspeptic symptoms. The frequency of HP-positive patients in the present study was 13 , similar to that previously reported in the Japanese population 31 , so that our ndings may be generalizable to the Japanese population. However, because of the small sample size of the present study, larger studies are needed to con rm our ndings.…”

Seroprevalence of Helicobacter pylori in Korea: A multicenter, nationwide study conducted in 2015 and 2016

“…Japan has shown a decrease in H. pylori prevalence, similar to Korea. In several birth cohort studies from Japan, Japanese individuals born before 1950 showed a H. pylori prevalence rate of 80%‐90%, but those born during the 1980s showed a H. pylori prevalence of 10%‐20% 14, 15. Recent Japanese studies reported that the H. pylori seropositivity in junior high school students was only 3%‐5% 16, 17.…”

Epidemiology of Helicobacter pylori infection

“…A cross‐sectional study in Japan including 4285 subjects born between 1926 and 1989 revealed a permanent decline in H. pylori seroprevalence. The authors estimated the birth‐year percent change (BPC) for respective birth cohorts . The highest prevalence was in individuals born between 1927 and 1949 where prevalence was 54.0% and 42.0%, respectively, with a BPC of −1.2%.…”

“…This was followed by a rapid decline in those born between 1949 (42.0%) and 1961 (24.0%) (BPC −4.5%,), but in further birth cohorts born between 1961 (24.0%) and 1988 (14.0%), the BPC was −2.1%. The decline in prevalence could reflect improvements in social infrastructure and sanitary conditions during childhood, and these included municipal water supply introduction between 1950 and 1970 . In parallel with the decline of H. pylori prevalence, there was also a decline in subjects with high‐risk precancerous lesions (defined by pepsinogen levels and H. pylori prevalence) …”