Prevalence of Helicobacter Pylori in Aotearoa New Zealand for Māori, Pacific and other Populations — The Association Specialists
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  3. Prevalence of Helicobacter Pylori in Aotearoa New Zealand for Māori, Pacific and other Populations

Prevalence of Helicobacter Pylori in Aotearoa New Zealand for Māori, Pacific and other Populations (23915)

James Stanley 1 , Andrea Teng 1 , Virginia Signal 1 , Stephen Inns 1 2 , Kirsty Danielson 1 , Cheryl Davies 3 , Jin Young Park 4 , Melissa McLeod 1 , Viliami Puloka 1 , Diana Sarfati 5
  1. University of Otago, Wellington, New Zealand
  2. Health NZ Te Whatu Ora Capital Coast and Hutt Valley, Wellington
  3. Tū Kotahi Māori Asthma and Research Trust, Wellington, New Zealand
  4. Early Detection, Prevention, and Infections Branch, International Agency for Research on Cancer, Lyon, France
  5. Institute of Cancer Policy, Kings College, London, United Kingdom

Background: Helicobacter pylori (H. pylori) is the largest preventable cause of stomach cancer, with a high burden in many countries. Stomach cancer rates in Aotearoa New Zealand (NZ) show strong inequities by ethnicity, with previous estimates of community prevalence of H. pylori in NZ also reporting strong disparities, especially for Pacific peoples. However, these estimates used 20th century data, and relied on serology results that capture both active and historical (cleared) infection. Population screen-and-treat strategies can be used to reduce active infection, but deployment of such strategies requires up-to-date prevalence estimates.

Methods: The H. pylori in Aotearoa NZ (HpANZ) study is a community-based prevalence study (in field 2024-2025), using a two-stage testing process with initial ELISA serological testing followed (if positive) by stool-based antigen testing. We recruited participants stratified by ethnicity (Māori, Pacific, and non-Māori/non-Pacific) and age group (12-69 years). Results are age-standardised to the WHO standard population (ages 12-69).

Results: A total of 1107 participants provided at least one serology/stool result and contributed to the prevalence analysis (393 Māori; 267 Pacific; 447 non-Māori/non-Pacific). Serology showed highest age-standardised prevalence of ever-infection for Pacific (48%) followed by Māori (15%) and sole-European (9%). This patterning was also evident based on stool-tests, with lower prevalence of active-infection (Pacific 23%; Māori 7%; sole-European 4%). Prevalence within each group generally increased with age and other demographic factors.  

Conclusion: These findings provide the first national NZ data for community-level prevalence of active infection with H. pylori, and the first based on stool antigen tests. Prevalence was strongly patterned by age and showed substantial inequities by ethnicity, particularly for Pacific peoples. Results highlight the importance of H. pylori screen-and-treat to address stomach cancer inequities in Aotearoa.