{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:13:16Z","timestamp":1788567196938,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"vor","delay-in-days":46,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Helicobacter pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      infection is a primary cause of gastric cancer. Although eradication therapy in adulthood suppresses carcinogenesis, its efficacy is limited due to the progression of advanced gastric mucosal atrophy before eradication. Implementing a \u201cscreen\u2010and\u2010treat\u201d strategy during adolescence represents a promising approach to prevent advanced atrophy and subsequent gastric cancer.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective cohort study included first\u2010year high school students in Kyoto Prefecture, Japan, from 2015 to 2023. Screening was performed using a primary urine\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>H. pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      antibody test, followed by a secondary stool antigen test for confirmation. Confirmed positive individuals were referred to designated medical institutions for 7\u2010day eradication therapy. The primary therapeutic regimen was shifted from rabeprazole, amoxicillin, and clarithromycin (PAC) in 2015 to rabeprazole, amoxicillin, and metronidazole (PAM) from 2016 onward.\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Clostridium butyricum<\/jats:italic>\n                      <\/jats:styled-content>\n                      MIYAIRI 588 strain (CBM588) was co\u2010administered starting in 2017. Eradication success was verified via a stool antigen test at least 8\u2009weeks post\u2010treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 50,031 students were targeted over the 9\u2010year period, with an overall consent rate ranging from 59.9% to 83.9%. The confirmed\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>H. pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      infection rate declined from 4.7% in 2015 to 1.5% in 2023. The medical consultation rate among positive screenees exhibited a declining trend, peaking at 84.6% (2015) and dropping to 15.8% (2023), despite a temporary increase in 2019 (65.9%). The eradication success rate significantly improved from 76.5% with the PAC regimen (2015) to over 93.8% with the PAM regimen (2016 onward), exceeding 96.0% after the addition of CBM588. No serious adverse events were reported throughout the study period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The prospective adolescent screen\u2010and\u2010treat program demonstrated a significant decrease in\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>H. pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      infection rates among first\u2010year high school students over the decade. While the safety and efficacy of the PAM\u2010based eradication regimen were verified, declining medical consultation rates present a continuous challenge for public health implementation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hel.70156","type":"journal-article","created":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T17:40:52Z","timestamp":1786902052000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Decade of Screening and Treating\n                    <scp>\n                      <i>Helicobacter pylori<\/i>\n                    <\/scp>\n                    Infection Among First\u2010Year High School Students in Kyoto, Japan: Annual Trends in Infection, Consultation, and Eradication Success Rates (2015\u20132023)"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2228-0405","authenticated-orcid":false,"given":"Osamu","family":"Handa","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine Tokai University School of Medicine  Isehara Kanagawa Japan"},{"name":"Department of Gastroenterology and Hepatology Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5210-167X","authenticated-orcid":false,"given":"Kazuhiko","family":"Uchiyama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6119-4828","authenticated-orcid":false,"given":"Tomohisa","family":"Takagi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kyoto Prefectural University of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5443-788X","authenticated-orcid":false,"given":"Yuji","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kyoto Prefectural University of Medicine  Kyoto 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