Gastroenterologists Lack Consensus Regarding If, How, and When to Screen or Survey for Premalignant Gastric Lesions: Results of a Pilot Survey

Frye, Jeanetta; Sauer, Bryan G.; Gomez, Justin M.; Shami, Vanessa M.; Wang, Andrew

doi:10.14309/00000434-201210001-00100

Cited by 4 publications

(1 citation statement)

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“…With 723000 reported deaths in 2012, gastric cancer is the third most common cause of cancer-related mortality[ 1 , 2 ]. The annual incidence of gastric cancer in 2013 based upon the SEER database was 7.5 per 100000 persons with an annual death rate of 3.5 cases per 100000 in the United States population[ 3 ]. The lower prevalence of gastric cancer in Western countries is also associated with the diagnosis of gastric cancer at a later stage, which results in a poor 5-year survival of 20% within the United States[ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Gastric intestinal metaplasia is associated with gastric dysplasia but is inversely correlated with esophageal dysplasia

Gomez

Patrie

Bleibel

et al. 2017

WJGE

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AIMTo determine which clinical factors might be associated with gastric intestinal metaplasia (IM) in a North American population.METHODSPathology and endoscopy databases at an academic medical center were reviewed to identify patients with and without gastric IM on biopsies for a retrospective cohort study. Patient demographics, insurance status, and other clinical factors were reviewed.RESULTSFour hundred and sixty-eight patients with gastric IM (mean age: 61.0 years ± 14.4 years, 55.5% female) and 171 without gastric IM (mean age: 48.8 years ± 20.8 years, 55.0% female) were compared. The endoscopic appearance of atrophic gastritis correlated with finding gastric IM on histopathology (OR = 2.05, P = 0.051). Gastric IM was associated with histologic findings of chronic gastritis (OR = 2.56, P < 0.001), gastric ulcer (OR = 6.97, P = 0.015), gastric dysplasia (OR = 6.11, P = 0.038), and gastric cancer (OR = 6.53, P = 0.027). Histologic findings of Barrett’s esophagus (OR = 0.28, P = 0.003) and esophageal dysplasia (OR = 0.11, P = 0.014) were inversely associated with gastric IM. Tobacco use (OR = 1.73, P = 0.005) was associated with gastric IM.CONCLUSIONPatients who smoke or have the endoscopic finding of atrophic gastritis are more likely to have gastric IM and should have screening gastric biopsies during esophagogastroduodenoscopy (EGD). Patients with gastric IM are at increased risk for having gastric dysplasia and cancer, and surveillance EGD with gastric biopsies in these patients might be reasonable.

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