TREND TOWARD A REDUCED PREVALENCE OF HELICOBACTER PYLORI INFECTION, CHRONIC GASTRITIS, AND GASTRIC CANCER IN JAPAN

doi:10.1016/S0889-8553(05)70134-5

Gastroenterology Clinics of North America

Volume 29, Issue 3, 1 September 2000, Pages 623-631

https://doi.org/10.1016/S0889-8553(05)70134-5 Get rights and content

Although there has been a remarkable decline in the prevalence and mortality rates of gastric cancer in developed countries, gastric cancer is one of the common malignancies in the world and is still the main cause of death in Japan. Since the first description of Helicobacter pylori by Warren and Marshall³⁹ in 1983, evidence increasingly implicates this organism as a risk factor for gastric cancer.7, 9, 22, 29, 31, 35 Before the discovery of H. pylori, researchers focused on the role that atrophic gastritis and intestinal metaplasia play in the pathogenesis of gastric cancer.5, 6, 16, 18, 33 It is important to investigate the relationship between H. pylori infection and gastric cancer and gastritis to understand better mechanisms for carcinogenesis in the stomach. This article describes the trends in H. pylori infection and gastritis in Japan over the past few decades.

Section snippets

CHANGING PATTERNS OF GASTRIC CANCER IN JAPAN

Although the mortality rate of gastric cancer in Japan has declined (Fig. 1),¹ there is no obvious explanation for the decline. One possible explanation is the increase in detection of early gastric cancer. A previous study²¹ on clinicopathologic features of 861 patients with gastric cancer resected in 1975, 1985, and 1995 indicated that the prevalence of early gastric cancer increased from 27.4% in 1975, to 40.2% in 1985, to 65.6% in 1995 (Fig. 2). This increase is attributed to the spread of

TIME TRENDS IN HELICOBACTER PYLORI INFECTION AND IN GASTRITIS IN JAPAN

The prevalence of H. pylori infection is significantly higher in developing than in developed countries (Fig. 3)12, 13, 27 and is closely related to low socioeconomic status.12, 14 Japan is an exception among the developed countries in that the prevalence of H. pylori infection in people older than 50 years old is approximately 80%, which is similar to that in developing countries. Because Japan's position among developed nations emerged in the past few decades, it is important to investigate

SUMMARY

It is speculated that declines in H. pylori infection and gastritis over the past few decades may lead to a decline in gastric cancer in Japan, supplemented by excellent procedures for the early detection of gastric cancer. Because H. pylori infection rarely is acquired in adult life, once it is eradicated, reinfection would not be expected in adult patients. It seems likely that adequate treatment of H. pylori infection would provide long-term protection against gastric cancer.

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Cited by (26)

Occurrence of Helicobacter pylori in saliva from preschool-age children
2015, Oral Science International
Citation Excerpt :
H. pylori infection is reported to have a high incidence rate in developing countries and a low rate in developed countries [32]. In Japan, there is a biphasic pattern: the infection rate among people aged ≤20 years is approximately 20%, or roughly the same as in major developed countries, but among people aged ≥50 years, it is high at 60% or higher [22]. The infection rate is high in developing countries that do not have adequate water and sewer services or have a poor sanitation environment [19,32], and reports from China [33] and Russia [34], where there has been remarkable economic growth and the sanitation environment is being improved, show a biphasic pattern of infection similar to Japan.
It is known that initial infection with Helicobacter pylori can occur in children aged 5 years or less, but there have been no studies investigating the period of initial infection. Here, 418 children attending preschool, and their parents, were tested for H. pylori DNA by real-time PCR using saliva samples in order to infer the period of initial infection of H. pylori.
Subjects took samples of their saliva by chewing on a sterile absorbent cotton roll for 2 minutes, and samples were stored at −80̊C until they were examined. DNA was extracted from 100 μl of saliva and was tested for H. pylori DNA using the TaqMan method.
The H. pylori DNA detection rate among children was: 4.1% among 3-year-olds, 4.9% among 4-year-olds, 10.0% among 5-year-olds, and 13.3% among 6-year-olds. The detection rate thus increased with age, showing a sharp increase from age 4 to 5 years. The rate of H. pylori detection among mothers of H. pylori-positive children was 56.2%, which was significantly greater than the rate among mothers of H. pylori-negative children (17.2%).
These results suggest that initial infection occurs even in children aged under 3 years, and the rise in detection rate between age 4 and 5 years suggests that there is a high risk of H. pylori infection during this period. Furthermore, the finding that the positivity rate was significantly higher among mothers of H. pylori-positive children than mothers of H. pylori-negative children indicates that mother-child infection is the most important route.
Prevalence and risk-factors for Helicobacter pylori infection in urban and rural Beninese populations
2005, Clinical Microbiology and Infection
Citation Excerpt :
Helicobacter pylori infection is associated with a range of gastric and duodenal lesions [1–3], and is a class I carcinogenic agent, involved in gastric carcinogenesis as well as in development of gastric lymphomas of the MALT type [1–3].
In total, 446 healthy individuals (240 in urban and 206 in rural environments, respectively) were selected from 96 households, based on cluster sampling of residential location. Demographic, sociological and environmental data were collected by face-to-face interviews using a standard questionnaire. Infection with Helicobacter pylori was assessed by detection of anti-H. pylori IgG serum antibodies. The prevalence of H. pylori antibodies was 75.4% in the urban population and 72.3% in rural (village) residents (p 0.459). No association was found between infection and age, gender, education level, size of household, economic activity or source of drinking water. The infection rate was higher in children whose parents were both infected, and also in children whose mother was infected (p < 0.001). By logistic regression analysis, the density of occupation of sleeping accommodation (more than three persons sharing a room; 95% odds ratio (OR) = 9.82 (4.13–23.31), p < 0.001), and the mother's status within the household (95% OR = 3.85 (1.53–9.67), p 0.003), were independent predictors for H. pylori infection. The 74% seroprevalence of H. pylori infection found in healthy Beninese individuals is similar to that reported previously from other parts of sub-Saharan Africa. Family contact with infected persons and crowded living conditions were associated with increased risk of infection. These findings are consistent with intra-familial H. pylori transmission and suggest that improvement of living conditions should be protective against infection.
Influence of Living Environment during Childhood on Helicobacter pylori Infection in Japanese Young Adults
2020, Digestion
Gastric polyps diagnosed by double-contrast upper gastrointestinal barium X-ray radiography mostly arise from the Helicobacter pylori-negative stomach with low risk of gastric cancer in Japan
2017, Gastric Cancer
Different Pathophysiology of Gastritis in East and West? A Western Perspective
2016, Inflammatory Intestinal Diseases
Prevalence and risk factors of Helicobacter pylori infection in asymptomatic Chinese children: A prospective, cross-sectional, population-based study
2015, Alimentary Pharmacology and Therapeutics

View all citing articles on Scopus

: Address reprint requests to Ken Haruma, MD, Gastrointestinal Unit, First Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734, Japan, e-mail: [email protected]

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TREND TOWARD A REDUCED PREVALENCE OF HELICOBACTER PYLORI INFECTION, CHRONIC GASTRITIS, AND GASTRIC CANCER IN JAPAN

Section snippets

CHANGING PATTERNS OF GASTRIC CANCER IN JAPAN

TIME TRENDS IN HELICOBACTER PYLORI INFECTION AND IN GASTRITIS IN JAPAN

SUMMARY

Gastroenterology

Epidemiolology of Helicobacter pylori. in an asymptomatic population in the United States: Effect of age, race, and socioeconomic status

Gastroenterology

Am J Gastroenterol

Lancet

Lancet

Lancet

Gastroenterology

Lancet

Age-adjusted death rates of cancer by site and year in Japan

The cohort effect and Helicobacter pylori.

J Infect Dis

UICC workshop of the project on evaluation screening programs for gastrointestinal cancer

Int J Cancer

A human model of gastric carcinogenesis

Cancer Res

Carcinoma and intestinal metaplasia of the stomach in Colombian migrants

J Natl Cancer Inst

Helicobacter pylori and gastric carcinoma: Serum antibody prevalence in populations with contrasting cancer risks

Cancer

When is Helicobacter pylori infection acquired?

Gut

An international association between Helicobacter pylori infection and gastric cancer

Lancet

Epidemiology of, and risk factors, Helicobacter pylori infection among 3194 asymptomatic subjects in 17 populations

Gut

Seroprevalence of Helicobacter pylori in a birth cohort of 21-year-old New Zealanders

Eur J Gastroenterol Hepatol