In a recent publication in Gastroenterology, researchers conducted a systematic review and meta-analysis to examine the secular trend of the global prevalence of H pylori infection in adults and children/adolescents and explain its correlation to the incidence of gastric cancer.

The authors wrote, “Eradication of Helicobacter (H) pylori reduces the risk of gastric cancer in infected individuals. However, whether reduction of H pylori prevalence is accompanied by the reduction of gastric cancer incidence in the population remains uncertain. The prevalence of H pylori infection varies greatly depending on age, associated diseases, geographic regions, race/ethnicity, socioeconomic status, and hygienic conditions.”

The authors noted that this study was the first comprehensive study to assess the most recent prevalence of H pylori infection in individual countries across the globe from 2010 to 2022 and the secular trend over the past 3 decades in both adults and children/adolescents, as well as its associations with the secular trend of incidence of gastric cancer.

The researchers computed overall prevalence, corrected 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.

The researchers screened 16,976 articles, and 1,748 articles from 111 countries were eligible for analysis. The results revealed that the crude global prevalence of H pylori declined from 52.6% before 1990 to 43.9% in adults from 2015 through 2022; however, from 2015 through 2022, the incidence was still considered elevated, reported as 35.1% in both children and adolescents.

The authors wrote, “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 adolescents. H pylori prevalence was significantly reduced 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.”

The authors concluded that public health initiatives to diminish the incidence of H pylori as a tactic to decrease the incidence of gastric cancer in the population should be validated in large-scale clinical trials.

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