Global Prevalence of Helicobacter pylori Infection and Incidence of Gastric Cancer Between 1980 and 2022.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of observational studies
PubMed 38176660 · doi:10.1053/j.gastro.2023.12.022
What was done
Authors conducted a systematic review and multivariate meta-regression of 1,748 articles from 111 countries (screened from 16,976 records) assessing secular trends in Helicobacter pylori infection prevalence from 1980 to 2022 in adults and children/adolescents. Trends were compared with gastric cancer incidence rates from the Global Burden of Disease Study and Cancer Incidence in Five Continents.
What was found
Crude global H. pylori prevalence in adults decreased from 52.6% (95% CI, 49.6% to 55.6%) before 1990 to 43.9% (95% CI, 42.3% to 45.5%) during 2015 to 2022. Multivariate regression showed a 15.9% decline (95% CI, -20.5% to -11.3%) over the last 3 decades in adults, with significant regional reductions in the Western Pacific, Southeast Asian, and African regions. In children and adolescents, prevalence during 2015 to 2022 remained at 35.1% (95% CI, 30.5% to 40.1%), with no significant reduction over time globally or in any WHO region. Gastric cancer incidence decreased globally and in countries with declining H. pylori prevalence.
Why it matters
This establishes that while adult H. pylori infection has fallen globally over thirty years, childhood and adolescent infection rates remain high at over one in three with no observed secular decline.
Limits
The abstract does not state the total participant sample size, diagnostic methods used across included studies, or numerical estimates for the association with gastric cancer trends. The relation to gastric cancer incidence is ecological and prone to confounding.
Cited by
- contradicts Approximately 80% of the human population is colonized with Helicobacter pylori.
- contradicts Eighty percent of the population has Helicobacter pylori without it causing problems.