Time Trends in Helicobacter pylori Infection and Atrophic Gastritis Over 40 Years in Japan. Issue 3 (7th January 2015)

• Record Type: Journal Article
• Authors: Kamada, Tomoari; Haruma, Ken; Ito, Masanori; Inoue, Kazuhiko; Manabe, Noriaki; Matsumoto, Hiroshi; Kusunoki, Hiroaki; Hata, Jiro; Yoshihara, Masaharu; Sumii, Koji; Akiyama, Takashi; Tanaka, Shinji; Shiotani, Akiko; Graham, David Y.
• Is Part Of: Helicobacter. Volume 20:Issue 3(2015:Jun.)
• Page Start: 192
• Page End: 198
• Publication Date: 2015-01-07
• Subjects: Helicobacter -- Periodicals; Helicobacter infections -- Periodicals; Stomach -- Diseases -- Periodicals; 616.3301405
• DOI: 10.1111/hel.12193
• Languages: English
• ISSNs: 1083-4389

Abstract

<abstract abstract-type="main" id="hel12193-abs-0001"> <title>Abstract</title> <sec id="hel12193-sec-0001" sec-type="section"> <title>Background</title> <p> <italic>Helicobacter pylori</italic> infection produces progressive mucosal damage that may eventually result in gastric cancer. We studied the changes that occurred in the presence and severity of atrophic gastritis and the prevalence of <italic>H. pylori</italic> infection that occurred coincident with improvements in economic and hygienic conditions in Japan since World War II.</p> </sec> <sec id="hel12193-sec-0002" sec-type="section"> <title>Materials and Methods</title> <p>The prevalence of <italic>H. pylori</italic> infection and histologic grades of gastric damage were retrospectively evaluated using gastric biopsy specimens obtained over a 40‐year period. Gastric atrophy and intestinal metaplasia were scored using the updated Sydney classification system.</p> </sec> <sec id="hel12193-sec-0003" sec-type="section"> <title>Results</title> <p>The prevalence of <italic>H. pylori</italic> and severity of atrophy were examined in 1381 patients including 289 patients examined in the 1970s (158 men; mean age, 44.9 years), 787 in the 1990s (430 men; 44.2 years), and 305 in the 2010s (163 men; 53.2 years). Overall, the prevalence of <italic>H. pylori</italic> infection decreased significantly from 74.7% (1970s) to 53% (1990s) and 35.1% (2010s) (<italic>p</italic> < .01). The prevalence of atrophy in the antrum and corpus was significantly lower in the 2010s (33, 19%, respectively) compared to those evaluated in either the 1970s (98, 82%) (<italic>p</italic> < .001) or 1990s (80, 67%) (<italic>p</italic> < .001). The severity of atrophy and intestinal metaplasia also declined remarkably among those with <italic>H. pylori</italic> infection.</p> </sec> <sec id="hel12193-sec-0004" sec-type="section"> <title>Conclusions</title> <p>There has been a progressive and rapid decline in the prevalence of <italic>H. pylori</italic> infection as well a fall in the rate of progression of gastric atrophy among <italic>H. pylori‐</italic>infected Japanese coincident with the westernization and improvements in economic and hygienic conditions in Japan since World War II.</p> </sec> </abstract>