A Helicobacter pylori screening and treatment program to eliminate gastric cancer among junior high school students in Saga Prefecture: a preliminary report

J Gastroenterol. 2019 Aug;54(8):699-707. doi: 10.1007/s00535-019-01559-9. Epub 2019 Feb 15.

Abstract

Background: To present the strategies and preliminary findings of the first 3 years after implementing a Helicobacter pylori screening and eradication program to prevent gastric cancer in Saga Prefecture.

Methods: A screening and treatment program to eradicate H. pylori from third-grade junior high students was started in Saga Prefecture in 2016, using local governmental grants. Screening was with urinary anti-H. pylori antibody tests, followed by H. pylori stool antigen tests for students who were antibody positive. Those positive on both tests underwent H. pylori eradication by triple therapy based on a potassium-competitive acid blocker.

Results: From 2016 to 2018, the participation rate was 83.1% and the H. pylori infection rate was 3.1% (660/21,042). The participation rates were higher in 2017 (85.4%) and 2018 (85.9%) compared with 2016 (78.5%) (P < 0.0001), and the infection rate also decreased in a time-dependent manner (2016: 3.6%, 2017: 3.3%, 2018: 2.5%, P = 0.0001). In total, 501 students positive for H. pylori received eradication therapy (85.1% success) and adverse events occurred in 20 of these (4.0%). However, no serious complications occurred.

Conclusions: The H. pylori screening and eradication project for school students in Saga Prefecture has started successfully and we have seen both a steady increase in the participation rate and a steady decrease in the infection rate, without major safety concerns.

Keywords: Adverse effect; Eradication; Potassium-competitive acid blocker; Prevention.

MeSH terms

  • Adolescent
  • Early Detection of Cancer / methods
  • Female
  • Helicobacter Infections / complications
  • Helicobacter Infections / diagnosis*
  • Helicobacter Infections / drug therapy
  • Helicobacter pylori / isolation & purification*
  • Humans
  • Japan
  • Longitudinal Studies
  • Male
  • Mass Screening / methods*
  • Stomach Neoplasms / microbiology
  • Stomach Neoplasms / prevention & control*
  • Students
  • Time Factors