Global Prevalence of Helicobacter pylori Infection and Incidence of Gastric Cancer Between 1980 and 2022

Abstract

Background & AimsWe aimed to assess the secular trend of the global prevalence of H. pylori infection in adults and children/adolescence and to show its relation to that of gastric cancer incidence. MethodsWe performed a systematic review and meta-analysis to calculate overall prevalence, adjusted by multivariate meta-regression analysis. The incidence rates of gastric cancer were derived from the Global Burden of Disease Study and Cancer Incidence in Five Continents. ResultsOf the 16,976 articles screened, a total of 1,748 articles from 111 countries were eligible for analysis. The crude global prevalence of H. pylori has reduced from 52.6% (95% CI 49.6-55.6) before 1990 to 43.9% (95% CI: 42.3-45.5) in adults during 2015-2022, but was as still as high as 35.1% (95% CI: 30.5 -40.1) in children and adolescents during 2015-2022. Secular trend and multivariate regression analyses showed that the global prevalence of H. pylori has declined by 15.9% (95% CI -20.5 to -11.3) over the last three decades in adults, but not in children and adolescence. Significant reduction of H. pylori prevalence was observed in adults in the Western-Pacific, South-East Asian, and African regions. However, there was no significant reduction of the H. pylori prevalence in children and adolescence in any WHO regions. The incidence of gastric cancer has decreased globally and in various countries where the prevalence of H. pylori infection has declined. ConclusionsThe global prevalence of H. pylori infection has declined during the last three decades in adults, but not in children and adolescence. The results raised the hypothesis that public health drive to reduce the prevalence of H. pylori as a strategy to reduce the incidence of gastric cancer in the population, which should be confirmed in large scale clinical trials.