We read the systematic review and meta-analysis by Hooi et al1 with great interest. Their efforts should be commended for updating and expanding on global prevalence data on Helicobacter pylori infection that were published a few years ago.2 However, the data presented in their article did not capture current epidemiologic changes and the status quo in Asian countries, particularly those in Japan. Our estimate3 finds the prevalence of H pylori in Japan is rapidly decreasing owing in part to the abrupt increase in the number of patients who have been cured of H pylori infection (around 1.4 million per year from around 0.6 million from previous years) since the 2013 change in the health insurance policy to cover H pylori gastritis.