Esophagus to Small Intestine

Gastroenterology. 2024;166(4):605–19

Chen YC, Malfertheiner P, Yu HT, Kuo CL, Chang YY, Meng FT, Wu YX, Hsiao JL, Chen MJ, Lin KP, Wu CY, Lin JT, O’Morain C, Megraud F, Lee WC, El-Omar EM, Wu MS, Liou JM

Global prevalence of Helicobacter pylori infection and incidence of gastric cancer between 1980 and 2022


Background and aims: The authors aimed to assess the secular trend of the global prevalence of Helicobacter pylori infection in adults and children/adolescents and to show its relation to that of gastric cancer incidence.
Methods: They 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.
Results: Of the 16,976 articles screened, 1748 articles from 111 countries were eligible for analysis. The crude global prevalence of H. pylori has reduced from 52.6% (95% confidence interval [CI]: 49.6–55.6%) before 1990 to 43.9% (95% CI: 42.3–45.5%) in adults during 2015 through 2022, but was still as high as 35.1% (95% CI: 30.5–40.1%) in children and adolescents during 2015 through 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 3 decades in adults, but not in children and adolescents. Significant reduction of H. pylori prevalence was observed in adults in the Western Pacific, Southeast Asian, and African regions. However, H. pylori prevalence was not significantly reduced in children and adolescents in any World Health Organization regions. The incidence of gastric cancer has decreased globally and in various countries where the prevalence of H. pylori infection has declined.

Conclusions: The global prevalence of Helicobacter pylori infection has declined during the last 3 decades in adults, but not in children and adolescents. The results raised the hypothesis that the public health drive to reduce the prevalence of H. pylori as a strategy to reduce the incidence of gastric cancer in the population should be confirmed in large-scale clinical trials.

J.-M. Liou, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University, College of Medicine, Taipei, Taiwan, E-Mail: jyhmingliou@gmail.com or 010002@ntuh.gov.tw

DOI: 10.1053/j.gastro.2023.12.022

Back to overview

this could be of interest:

Early initiation of biologics and disease outcomes in adults and children with inflammatory bowel diseases: Results from the epidemiology group of the nationwide Israeli Inflammatory Bowel Disease Research Nucleus cohort

Gastroenterology. 2024;166(5):815–25.e22

Understanding the malignant potential of gastric metaplasia of the oesophagus and its relevance to Barrett’s oesophagus surveillance: Individual-level data analysis

Gut. 2024;73(5):729–40

More articles on the topic