Alyssa Y Choi1, Lisa L Strate2, Matthew C Fix3, Rodney A Schmidt4, Alexander R Ende2, Matthew M Yeh4, John M Inadomi2, Joo Ha Hwang2. 1. Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA. 2. Division of Gastroenterology, University of Washington School of Medicine, Seattle, Washington, USA. 3. Department of Biostatistics, University of Washington School of Medicine, Seattle, Washington, USA. 4. Department of Pathology, University of Washington School of Medicine, Seattle, Washington, USA.
Abstract
BACKGROUND AND AIMS: Although the incidence of gastric cancer is higher than that of esophageal cancer in the United States, no screening or surveillance guidelines exist. The aim of this study is to evaluate the association between gastric intestinal metaplasia and the risk of gastric cancer in a U.S. tertiary care system with a large immigrant population. METHODS: This is a retrospective case-control study with cases of biopsy-proven gastric cancer matched (by age and gender) to controls without gastric cancer who had undergone EGD. The presence of gastric intestinal metaplasia was ascertained from pathology reports. Other potential risk factors for gastric cancer were abstracted from medical records as follows: country of origin, Helicobacter pylori infection, family history of gastric cancer, alcohol consumption, smoking, and history of partial gastrectomy (Billroth I or II). Conditional logistic regression was used to identify independent risk factors for gastric cancer. RESULTS: One hundred fifty-two cases of gastric cancer were compared with 456 age- and gender-matched controls. The mean age was 66 years, and 57% were male. Multivariable analysis identified 2 significant predictors of gastric cancer: the presence of gastric intestinal metaplasia (odds ratio [OR], 9.3; 95% confidence interval [CI], 4.5-18.9; P < .001) and East Asian ethnicity (OR, 15.9; 95% CI, 5.8-43.6; P < .001). CONCLUSION: The presence of gastric intestinal metaplasia on endoscopy and East Asian ethnicity were significant risk factors for gastric cancer. Screening East Asian immigrants and surveying patients with gastric intestinal metaplasia may improve the rates of early detection of gastric cancer in the United States.
BACKGROUND AND AIMS: Although the incidence of gastric cancer is higher than that of esophageal cancer in the United States, no screening or surveillance guidelines exist. The aim of this study is to evaluate the association between gastric intestinal metaplasia and the risk of gastric cancer in a U.S. tertiary care system with a large immigrant population. METHODS: This is a retrospective case-control study with cases of biopsy-proven gastric cancer matched (by age and gender) to controls without gastric cancer who had undergone EGD. The presence of gastric intestinal metaplasia was ascertained from pathology reports. Other potential risk factors for gastric cancer were abstracted from medical records as follows: country of origin, Helicobacter pylori infection, family history of gastric cancer, alcohol consumption, smoking, and history of partial gastrectomy (Billroth I or II). Conditional logistic regression was used to identify independent risk factors for gastric cancer. RESULTS: One hundred fifty-two cases of gastric cancer were compared with 456 age- and gender-matched controls. The mean age was 66 years, and 57% were male. Multivariable analysis identified 2 significant predictors of gastric cancer: the presence of gastric intestinal metaplasia (odds ratio [OR], 9.3; 95% confidence interval [CI], 4.5-18.9; P < .001) and East Asian ethnicity (OR, 15.9; 95% CI, 5.8-43.6; P < .001). CONCLUSION: The presence of gastric intestinal metaplasia on endoscopy and East Asian ethnicity were significant risk factors for gastric cancer. Screening East Asian immigrants and surveying patients with gastric intestinal metaplasia may improve the rates of early detection of gastric cancer in the United States.
Authors: Robert J Huang; Nicole Sung-Eun Kwon; Yutaka Tomizawa; Alyssa Y Choi; Tina Hernandez-Boussard; Joo Ha Hwang Journal: JCO Clin Cancer Inform Date: 2022-06
Authors: Lu Yao Zhang; Jian Zhang; Dan Li; Yuan Liu; Dong Ling Zhang; Cai Fang Liu; Na Wang; Si Ran Wu; Wen Quan Lu; Jing Zhi Guo; Yong Quan Shi Journal: J Dig Dis Date: 2021-05-06 Impact factor: 2.325
Authors: William Waddingham; Stella A V Nieuwenburg; Sean Carlson; Manuel Rodriguez-Justo; Manon Spaander; Ernst J Kuipers; Marnix Jansen; David G Graham; Matthew Banks Journal: Frontline Gastroenterol Date: 2020-07-30