Abstract
Changing trends in the prevalence of H. pylori infection in the general population over time are thought to be the main driving force behind the declining gastric cancer mortality in Japan. However, whether the prevalence of H. pylori infection itself shows a birth-cohort pattern needs to be corroborated. We performed a systematic review of studies that reported the prevalence of H. pylori infection among Japanese individuals. Meta-regression was conducted in the framework of a generalized additive mixed model (GAMM) to account for heterogeneity in the prevalence of H. pylori infection as a function of birth year. The prevalence of H. pylori infection confirmed a clear birth cohort pattern: the predicted prevalence (%, 95% CI) was 60.9 (56.3–65.4), 65.9 (63.9–67.9), 67.4 (66.0–68.7), 64.1 (63.1–65.1), 59.1 (58.2–60.0), 49.1 (49.0–49.2), 34.9 (34.0–35.8), 24.6 (23.5–25.8), 15.6 (14.0–17.3), and 6.6 (4.8–8.9) among those who were born in the year 1910, 1920, 1930, 1940, 1950, 1960, 1970, 1980, 1990, and 2000, respectively. The present study demonstrated a clear birth-cohort pattern of H. pylori infection in the Japanese population. The decreased prevalence of H. pylori infection in successive generations should be weighed in future gastric cancer control programs.
Highlights
Helicobacter pylori (H. pylori), a gram-negative bacterium that colonizes the human stomach, has been evolving with humans for tens of thousands of years
Previous studies conducted in the Western population have suggested that gastric cancer, gastric ulcer and duodenal ulcer, the three main H. pylori-related diseases, exhibit a similar birth cohort pattern, with lower rates observed in subsequent generations[7]
There is no systematic review or meta-analysis consolidating the data on the prevalence of H. pylori infection from studies involving Japanese individuals
Summary
Helicobacter pylori (H. pylori), a gram-negative bacterium that colonizes the human stomach, has been evolving with humans for tens of thousands of years. These findings have shown that the prevalence of H. pylori infection increases with age[5] This phenomenon is presumably due to a birth-cohort effect, because almost all H. pylori infection is acquired prior to the age of five, and because the environment during early childhood, such as water supply system, socioeconomic status, household living environment and hygiene habits, is closely associated with H. pylori infection[6]. We aimed to derive a robust prevalence estimate of H. pylori infection by birth year, and to explore the factors that may be associated with between-study variations in H. pylori infection in our meta-regression analysis. These findings will help to inform gastric cancer screening policies
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