Taiji Akamatsu

Suzaka Prefectural Hospital, Japan

Title: Screening to Identify and Eradicate Helicobacter pylori Infection in Teenagers in Japan

Biography

Abstract

To elucidate the prevalence and effect of H. pylori infection in Japanese teenagers, we underwent an examination and treatment of it in one high school health screening between 2007 and 2013. The study subjects were students ages 16 to 17. Students who tested positive on this screening using urine based rapid test kits (RUPIRAN®) examination visited Shinshu University Hospital and underwent esophagogastroduodenoscopy (EGD) and were taken biopsy samples to determine their H. pylori status using culture and histology. Cure of H. pylori infections was determined by urea breath test. For 7 years, 3,251 of 3,263 students (99.6%) received a screening examination for H. pylori infection. One hundred and thirty-six of 3,251 students (4.2%) were positive for H. pylori. Seventy four of these 136 H. pylori positive students visited our hospital and 72 underwent EGD and 60 (83.3%) were confirmed to be H. pylori infected. The most common endoscopic findings for H. pylori infection were nodular gastritis (83.3%) and closed type atrophic gastritis (60.0%). Duodenal scar was recognized in 4 of them (6.7%) and intestinal metaplasia was histologically present in two. 56 of 60 students with H. pylori infection and their parents agreed to receive eradication therapy using regimens according to the susceptibility of H. pylori. Finally, all were successfully cured of H. pylori infection. If this procedure were to be introduced into nationwide health screening at Japanese high schools, we calculated that the cost of the prevention of a gastric cancer would be 481,144 yen (4,184 dollars) for each person. The low rate of prevalence of H. pylori infection in present Japanese teenagers would make it possible and cost effective to perform examinations and carry out treatment for this infection in nationwide health screenings of high school students.