Published online Oct 16, 2022. doi: 10.4253/wjge.v14.i10.597
Peer-review started: July 17, 2022
First decision: August 19, 2022
Revised: September 1, 2022
Accepted: September 21, 2022
Article in press: September 21, 2022
Published online: October 16, 2022
Gastric intestinal metaplasia (GIM) is a form of gastric pre-malignant lesions. It falls on the spectrum of the Correa cascade. The cascade includes chronic gastritis, atrophic gastritis, GIM, and dysplasia.
We designed this study to investigate factors leading to GIM formation. There is a lack of literature about this topic in the United States, especially among ethnic minorities, which are considered high-risk populations.
We aimed to identify factors that increase GIM formation in high-risk populations. These factors would help guide the future surveillance of selected patients and possibly suggest treatment modalities.
This is a retrospective longitudinal study in a tertiary hospital in Washington, DC. The study includes patients with at least two upper endoscopies with gastric biopsies to assess the evolution of GIM over time. A Cox regression model was built to investigate the significant factors over the study time.
Our study confirms that Ethnicity-Race minorities have a higher rate of GIM formation. We found that gastritis increases GIM formation over time. Helicobacter pylori in low-prevalence areas might not be a strong risk factor. Our results emphasize on future surveillance of minorities and management of gastritis as a way to reduce the burden of gastric cancer.
In conclusion, our study suggests that older age, having gastritis, or being from ethnic-race minorities is associated with an increased risk of GIM.
Further studies are needed to clarify factors associated with GIM progression and regression. This would help form a complete picture of the development and progression of gastric pre-malignant lesions.