Decreasing prevalence of Helicobacter pylori according to birth cohorts in urban China

Background/Aims: The Helicobacter pylori (H. pylori) prevalence has been decreasing in many parts of the world. This study aimed to investigate the current epidemiological status of H. pylori infection in urban China. Materials and Methods: The study included 51,299 subjects aged >= 18 years who underwent health checkups between April 2013 and June 2016 in a city of China. H. pylori infection was determined by detecting H. pylori urease-IgG antibodies. Statistical analyses included chi-square tests for trends and curve fitting. Results: The overall H. pylori prevalence was found to be 31.9%, with the highest prevalence in the 1950-1959 birth cohort. It was lower in the subsequent birth cohorts (trends, p< 0.001). The decrease in H. pylori prevalence was correlated with the increase in per capita gross domestic product (GDP) and real per capita GDP; the power model was best fitted (R-2= 0.914 and 0.997 and p= 0.011 and 0.000, respectively). Conclusion: There has been a striking decrease in the H. pylori prevalence in urban China. The birth cohort effect and economic growth are the most likely causes of this phenomenon.