Abstract
The acquisition ofHelicobacter pylori is the main cause of chronic gastritis in humans. In Europe, a small proportion (less than 1%) of gastritis cases are caused byH. Heilmannii, and somewhat more (5%) are autoimmune in origin, in which conditionH. pylori may not probably play a role. Recent findings on chronic gastritis andH. pylori acquisition in developed countries can be summarized as: (1)H. pylori gastritis is acquired in childhood and adolescence (age less than 20) in more than 50% of cases; (2) the risk and rate of acquisition is highest in early childhood, after which the rate exponentially declines; (3) new infectious occur in adulthood but are quite rare (annual incidence 0.4%, on average, in Finland); (4)H. pylori gastritis is a birth cohort-related phenomenon; i.e., different cohorts show a rate and prevalence ofH. pylori gastritis that varies between cohorts; (5) the rate and risk ofH. pylori infection is high in cohorts born in the beginning of the century, but is much lower in those born later; (6) this decline is due to a decrease in the rate and risk ofH. pylori acquisition in childhood in particular.H. pylori gastritis—related complications, such as peptic ulcer diseases and gastric cancer, show epidemiological features similar toH. pylori gastritis. Both peptic ulcer and gastric cancer have declined in incidence over time. Gastric cancer is a birth-cohort phenomenon in the same way as isH. pylori gastritis, and the incidence of gastric cancer shows a positive but exponential relationship with the “birth-cohort-specific” prevalence of gastritis in the general population.
Similar content being viewed by others
References
Price AB. The Sydney System: Histological division. J Gastroenterol Hepatol 1991;6:209–222.
Whitehead R, Truelove SC, Gear MW. The histological diagnosis of chronic gastritis in fibreoptic biopsy specimens. J Clin Pathol 1972;25:1–11.
Siurala M, Sipponen P, Kekki M. Chronic gastritis: Dynamic and clinical aspects. Scand J Gastroenterol 1985;20(Suppl 109): 69–76.
Valle H, Kekki M, Sipponen P, Siurala M. The natural history ofH. pylori gastritis: A 30-year histologic follow-up study. VIIIth International workshop on gastroduodenal pathology andHelicobacter pylori. Edinburgh, July 7–9, 1995.
Kuipers EJ, Pena AS, Kamp Van G, et al. Seroconversion ofHelicobacter pylori. Lancet 1993;342:328–331.
Sipponen P, Kekki M, Siurala M. The Sydney System: Epidemiology and natural history of chronic gastritis. J Gastroenterol Hepatol 1991;6:244–251.
Kekki M, Varis K, Pohjanpanpalo H, et al. Course of antrum and body gastritis in pernicious anemia families. Dig Dis Sci 1983;28:698–704.
Ihamäki T, Kekki M, Sipponen P, et al. The sequelae and course of chronic gastritis during a 30- to 40-year bioptic follow-up study. Scand J Gastroenterol 1985;20:485–491.
Siurala M, Sipponen P, Kekki M.Campylobacter pylori in a sample of Finnish population: Relations to morphology and functions of the gastric mucosa. Gut 1988;29:909–916.
Correa P. Chronic gastritis. In: Whitehead R (ed) Gastrointestinal and oesophageal pathology. Edinburgh: Churchill Livingstone, 1989:402–420.
Kekki M, Siurala M, Varis K, et al. Classification principles and genetics of chronic gastritis. Scand J Gastroenterol 1987;22(Suppl 141): 1–28.
Bonney G, Elston E, Correa P, et al. Genetic etiology of gastric carcinoma. I. Chronic gastritis. Genetic Epidemiol 1986;3:213–224.
Lee A, Dixon M, Danon SJ, et al. Local acid production andHelicobacter pylori: A unifying hypothesis of gastroduodenal disease. Eur J Gastroenterol Hepatol 1995;7:461–465.
Sipponen P, Hyvärinen H, Siurala M.H. pylori corpus gastritis— relation to acid output. J Physiol Pharmacol 1996;47:151–159.
Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy 1969;1:87–97.
Kimura K. Chronological transition of the fundic pyloric border determined by stepwise biopsy of the lesser and greater curvature of the stomach. Gastroenterology 1972;63:584–592.
Banatvala N, Mayo K, Megraud F, et al. The cohort effect andHelicobacter pylori. J Infect Dis 1993;168:219–221.
Parsonnet J, Blaser MJ, Perez-perez GI, et al. Symptoms and risk factors forHelicobacter pylori in a cohort of epidemiologists. Gastroenterology 1992;102:41–46.
Cullen DJ, Collins BK, Cullen KJ, et al. A 21-year follow-up ofHelicobacter pylori infection—the cohort theory proven. Gut 1993;33:S4.
Sipponen P, Helske T, Järvinen P, et al. Fall in the prevalence of chronic gastritis over 15 years; analysis of outpatients series in Finland from 1977, 1985, and 1992. Gut 1994;35:1167–1171.
Kuipers EJ, Pena AS, Kamp Van G, et al. Seroconversion forHelicobacter pylori. Lancet 1993;342:328–331.
Mendall MA, Goggin PM, Molineaux N, et al. Childhood living conditions andHelicobacter pylori seropositivity in adult life. Lancet 1992;339:896–897.
Jones DM, Eldridge J, Whorwell PJ. Antibodies toCampylobacter pyloridis in household contacts of infected people. BMJ 1987;294:615.
Hazell SL, Mitchell HM, Hu PJ, et al. Gastric cancer—is childhood acquisition ofH. pylori the key? Iris J Med Sci 1992;161: 22.
Megraud F, Brassens-Rabbe M-P, Denis F, et al. Seroepidemiology ofCampylobacter pylori infection in various populations. J Clin Microbiol 1989;27:1870–1873.
Graham DY.Helicobacter pylori: Its epidemiology and its role in duodenal ulcer disease. J Gastroenterol Hepatol 1991;6:105–113.
Sipponen P, Seppälä K. Long-term consequences ofH. pylori infection: Time trends inH. pylori gastritis, gastric cancer and peptic ulcer disease. In: Hunt RH, Tytgat GNJ (eds)Helicobacter pylori. Basic mechanisms to clinical cure. Dordrecht: Kluwer Academic, 1994:372–380.
Pounder RE, Ng D. The prevalence ofHelicobacter pylori infection in different coutries. Aliment Pharmacol Ther 1995;9(Suppl 2): 33–39.
Howson CP, Hiyama T, Wynder EL. The decline in gastric cancer: epidemiology of an unplanned triumph. Epidem Rev 1986;8:1–27.
Coggon D, Acheson ED. The geography of cancer of the stomach. Br Med Bull 1984;40:335–341.
Hakulinen T, Andersen AA, Malker B, et al. Trends in cancer incidence in the nordic countries. A collaborative study of the five nordic cancer registries. Acta Pathol Microbiol Immunol Scand (Sect A) 1986;94(Suppl 288):1–151.
Sonnenberg A. Temporal trends and geographical variations of peptic ulcer disease. Aliment Pharmacol Ther 1995;9(Suppl 2):3–21.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sipponen, P. Helicobacter pylori gastritis—Epidemiology. J Gastroenterol 32, 273–277 (1997). https://doi.org/10.1007/BF02936382
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02936382