Abstract
BACKGROUND: Helicobacter pylori infection increases the risk of developing gastric cancer. Early eradication is effective in reducing the risk. An increasing number of Japanese municipalities are implementing school-based H. pylori screening programs. This study examined an administrative initiative targeting junior high school students to reveal the challenges in enhancing child-centered screening efforts. MATERIALS AND METHODS: This study examined a 2019-2021 population-based H. pylori screening program that targeted second-year junior high school students in Yokosuka City, Japan. The program used a two-tiered approach: initial urine antibody testing, followed by urea breath tests for confirmation. Students with confirmed infections received eradication therapy, and the outcomes were monitored through follow-up testing. Data on participation rates, treatment efficacy, side effects, and family infection surveys were analyzed. RESULTS: Between 2019 and 2021, 6270 students in Yokosuka City participated in H. pylori screening, with a confirmed infection rate of 1.2%. First-line eradication therapy achieved a 52.9% success rate, which increased to 94.7% after the second-line treatment. Mild side effects, mainly diarrhea, were reported in 27.0% of the first-line and 22.0% of the second-line cases. Family surveys showed that 48.5% of the infected students had H. pylori-positive relatives, underscoring the importance of addressing familial transmission alongside treatment efforts. CONCLUSIONS: H. pylori has low prevalence among Japanese junior high school students in an urban area, with modest eradication success. The low participation and dropout rates highlight the need for improved strategies to boost engagement and ensure comprehensive screening and treatment for better program outcomes.