Journal of Preventive Medicine and Public Health

Original Article

Upper Endoscopy up to 3 Years Prior to a Diagnosis of Gastric Cancer Is Associated With Lower Stage of Disease in a USA Multiethnic Urban Population, a Retrospective Study: Shailja C. Shah, Chiaki Nakata, Alexandros D. Polydorides, Richard M. Peek, Steven H. Itzkowitz; J Prev Med Public Health. 2019;52(3):179-187. Published online April 26, 2019; DOI: https://doi.org/10.3961/jpmph.18.262

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Objectives
In the USA, certain races and ethnicities have a disproportionately higher gastric cancer burden. Selective screening might allow for earlier detection and curative resection. Among a USA-based multiracial and ethnic cohort diagnosed with non-cardia gastric cancer (NCGC), we aimed to identify factors associated with curable stage disease at diagnosis.
Methods
We retrospectively identified endoscopically diagnosed and histologically confirmed cases of NCGC at Mount Sinai Hospital in New York City. Demographic, clinical, endoscopic and histologic factors, as well as grade/stage of NCGC at diagnosis were documented. The primary outcome was the frequency of curable-stage NCGC (stage 0-1a) at diagnosis in patients with versus without an endoscopy negative for malignancy prior to their index exam diagnosing NCGC. Additional factors associated with curable-stage disease at diagnosis were determined.
Results
A total of 103 racially and ethnically diverse patients were included. Nearly 38% of NCGC were stage 0-Ia, 34% stage Ib-III, and 20.3% stage IV at diagnosis. A significantly higher frequency of NCGC was diagnosed in curable stages among patients who had undergone an endoscopy that was negative for malignancy prior to their index endoscopy that diagnosed NCGC, compared to patients without a negative endoscopy prior to their index exam (69.6% vs. 28.6%, p=0.003). A prior negative endoscopy was associated with 94.0% higher likelihood of diagnosing curable-stage NCGC (p=0.003). No other factors analyzed were associated with curable-stage NCGC at diagnosis.
Conclusions
Endoscopic screening and surveillance in select high-risk populations might increase diagnoses of curable-stage NCGC. These findings warrant confirmation in larger, prospective studies.

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Cáncer gástrico de intervalo: un llamado a la atención y a la acción
R. Castaño-Llano, A. Piñeres, R. Jaramillo, S. Molina, F. Aristizábal, J.E. Puerta
Revista de Gastroenterología de México.2023; 88(2): 91. CrossRef
Interval gastric cancer: A call to attentiveness and action
R. Castaño-Llano, A. Piñeres, R. Jaramillo, S. Molina, F. Aristizábal, J.E. Puerta
Revista de Gastroenterología de México (English Edition).2023; 88(2): 91. CrossRef

English Abstract

The Prevalence of Atrophic Gastritis and Intestinal Metaplasia according to Gender, Age and Helicobacter Pylori Infection in a Rural Population.: Hyun Ja Kim, Bo Youl Choi, Tae Joon Byun, Chang Soo Eun, Kyu Sang Song, Yong Sung Kim, Dong Soo Han; J Prev Med Public Health. 2008;41(6):373-379.; DOI: https://doi.org/10.3961/jpmph.2008.41.6.373

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Abstract PDF

OBJECTIVES
The objective of this study was to evaluate the prevalence of atrophic gastritis and intestinal metaplasia according to gender, age and Helicobacter pylori infection in a rural population in Korea. METHODS: Between April 2003 and January 2007, 713 subjects (298 men and 415 women, age range: 18-85) among the 2,161 adults who participated in a populationbased survey received gastrointestinal endoscopy. All the subjects provided informed consent. Multiple biopsy specimens were evaluated for the presence of atrophic gastritis and intestinal metaplasia. The presence of Helicobacter pylori was determined using CLO and histology testing. RESULTS: The age-adjusted prevalence of atrophic gastritis was 42.7% for men and 38.1% for women and the prevalence of intestinal metaplasia was 42.5% for men and 32.7% for women. The prevalence of atrophic gastritis and intestinal metaplasia increased significantly with age for both men and women (p for trend<0.001). The ageadjusted prevalence of Helicobacter pylori was similar for men (59.0%) and women (56.7%). The subjects with Helicobacter pylori infection showed a significantly higher prevalence of intestinal metaplasia (44.3%) compared with that (26.8%) of the noninfected subjects (p<0.001). However, the prevalence of atrophic gastritis was not statistically different between the Helicobacter pyloriinfected subjects and the noninfected individuals. CONCLUSIONS: Our findings suggest that the prevalence of atrophic gastritis and intestinal metaplasia is higher for a Korean rural population than that for a Western population; this may be related to the high incidence of gastric cancer in Koreans. Especially, the prevalence of intestinal metaplasia was high for the subjects with Helicobacter pylori infection. The multistep process of gastric carcinogenesis and the various factors contributing to each step of this process need to be determined by conducting future follow-up studies.

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Citations

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