This article is more than 5 years old. Information may no longer be current.
Gastric cancer risk higher in patients with incomplete gastric intestinal metaplasia, especially men
Click Here to Manage Email Alerts
Among patients with gastric intestinal metaplasia, the risk for dysplasia or early gastric cancer was increased in men and in patients with incomplete gastric intestinal metaplasia, according to the results of a 5-year retrospective cohort study.
“Gastric intestinal metaplasia (GIM) subtype is important and helpful for further management,” Rapat Pittayanon, MD, of the departments of gastroenterology at Chulalongkorn University and King Chulalongkorn Memorial Hospital in Bangkok, Thailand, and McGill University and the McGill University Health Center in Montreal, Canada, told Healio Gastroenterology. “Incomplete type GIM, especially in males, is a strong risk factor of the development of high grade dysplasia and early gastric cancer, regardless of gastric cancer prevalence.”
To better select high-risk patients for surveillance endoscopy, Pittayanon and colleagues sought to identify risk factors for gastric cancer in patients with GIM within the Thai population, which shows a low prevalence of gastric cancer at about 5.5 per 100,000. They identified 91 patients diagnosed with GIM between 2004 and 2014 at King Chulalongkorn Memorial Hospital, who then had surveillance with upper endoscopy every 6 or 12 months for 5 years (51% men; mean age, 63 years).
At diagnosis, 89% of patients had complete GIM, none of whom progressed to cancer during the study. Conversely, half of the 10 patients initially diagnosed with incomplete GIM progressed to either high-grade dysplasia (n = 2) or cancer (n = 3).
The researchers associated male sex (P = .027) and incomplete GIM (P = .001) with an increased risk for developing dysplasia or cancer through the follow-up period. They also identified a nonsignificant trend potentially associating smoking with an increased risk for dysplasia or cancer in these patients (P = .08).
Pittayanon and colleagues concluded that future research is still required to identify the best surveillance intervals for these at-risk patients.
“Endoscopic surveillance by 6-monthly intervals in patient with incomplete type GIM may detect early stage of gastric cancer, as well as provide curative treatment,” Pittayanon said. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts