Downward trend in the prevalence of Helicobacter pylori infections and corresponding frequent upper gastrointestinal diseases profile changes in Southeastern China between 2003 and 2012

Abstract

This present study aims to determine trends in the prevalence of H. pylori infections in Southeastern China between 2003 and 2012, and investigate corresponding changes in the prevalence of upper gastrointestinal diseases. This retrospective study screened 196,442 patients with a mean age of 47.49 ± 14.47 years (age range 5–100 years) in Southeastern China, and a total of 134,812 cases of an endoscopy-referral patient population with digestive symptoms between 2003 and 2012 were enrolled. Based on esophago-gastro-duodenoscopy and pathology, patients diagnosed with chronic gastritis, peptic ulcer, gastric cancer or reflux esophagitis were included in this study. Basic demographic and clinical characteristics such as H. pylori infection status and endoscopic findings were collected and analyzed. Among the 134,812 subjects, mean prevalence of H. pylori infection was 31.97 %; which demonstrated a linear downward trend from 42.40 to 23.82 % (P < 0.001) at an annual rate of 2 % from 2003 to 2012. Similarly, the prevalence of duodenal and gastric ulcer rapidly decreased from 12.65 to 6.57 % and from 7.51 to 3.78 %, respectively; while the prevalence of gastric cancer (from 3.76 to 2.34 %) did not significantly change in the same time period. In contrast, the prevalence of reflux esophagitis increased from 6.19 to 12.80 %. The progressively decreasing prevalence of H. pylori infections from 2003 to 2012 in Southeastern China appears to be linked with the decline of related upper gastrointestinal diseases and increase of some gastrointestinal motility diseases.

Decreasing prevalence of Helicobacter pylori according to birth cohorts in urban China

“…The H. pylori prevalence decreased from 42.40% to 23.82%. Meanwhile, the prevalence of duodenal and gastric ulcer rapidly decreased from 12.65% to 6.57% and from 7.51% to 3.78%, respectively (27). Therefore, chronic gastric diseases appear to be decreasing with the decreasing H. pylori prevalence.…”

Ethnic/racial differences in gastrointestinal symptoms and diagnosis associated with the risk of <em>Helicobacter pylori</em> infection in the US

“… 2 Furthermore, Hispanics, Native Americans/Alaskan Natives (NA/ANs), and Asians have much higher rates of HP seropositivity than the white population. 3 – 5 …”

Chinese consensus on chronic gastritis (2017, Shanghai)

“…The prevalence of chronic gastritis in the population is therefore higher or slightly higher than the H. pylori infection rate. At present, the prevalence of endoscopically confirmed chronic gastritis is close to 90% in China …”

“…H. pylori infection during childhood can lead to chronic gastritis that mainly affects the gastric body, while those in adults mainly lead to antral gastritis . The incidence of chronic gastritis in China is on the rise, while the infection rate of H. pylori is trending downward . The H. pylori infection rate in China has dropped from 60.5% in 2000 to a current rate of 52.2% .…”