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Ethnicity Is an Important Consideration in Screening for Gastric Intestinal Metaplasia

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Abstract

Background

Gastric intestinal metaplasia (GIM) is a precursor to gastric adenocarcinoma, making it an attractive target for early detection by endoscopy. The aim of this study was to determine the prevalence, risk factors, and associated histologic findings of GIM among patients undergoing endoscopy in a diverse US population.

Methods

We conducted a retrospective, cross-sectional study of patients undergoing elective endoscopy with gastric biopsies at 6 academic and community centers in Houston, Texas. GIM prevalence was estimated with a 95% confidence interval (CI), and patient demographic and clinical characteristics were summarized using mean with standard deviation, or frequency with percentage. Generalized estimating equations (GEE) were used to compare characteristics between those with and without GIM.

Results

Our final cohort consisted of 2685 patients, including 216 cases with GIM and 2469 controls. The prevalence of GIM in our cohort was 8.04% (95% CI 7.07%, 9.14%). The mean age of GIM cases was higher than in the control group (59.8 vs 54.7 years, p < 0.0001). The prevalence of GIM in Asians, Hispanic, Black and Non-Hispanic Whites (NHW) was 14.7%, 11.7%, 9.8% and 5.8%, respectively. On multivariable analysis, factors associated with GIM include age (adj. OR 1.32 per 10 year increase, p < 0.0001), habitual smoking (adj. OR 1.68, p < 0.0001), and race (compared to NHW: Asian, adj. OR 2.34, p = 0.010; Hispanic, adj. OR 2.15, p < 0.001; Black, adj. OR 1.61, p < 0.001).

Conclusion

Asians, Hispanics, and African Americans have higher rates of GIM than NHW. Ethnicity should be an important consideration on determining who to screen for GIM in the US.

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Authors and Affiliations

  1. Section of Gastroenterology and Hepatology, Baylor College of Medicine, 7200 Cambridge Street. Suite 8A, Houston, TX, 77030, USA

    Eugene Kligman, Mimi C. Tan, Kalpesh Patel & Mohamed O. Othman

  2. Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Hiba Ali, Ellie Chen, Frederick Peng & David Szafron

  3. Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA

    Kristen Staggers

  4. Baylor St Luke’s Medical Center, Houston, TX, USA

    Mohamed O. Othman

Authors
  1. Eugene Kligman
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  2. Hiba Ali
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  3. Ellie Chen
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  4. Frederick Peng
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  5. David Szafron
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  6. Kristen Staggers
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  7. Mimi C. Tan
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  9. Mohamed O. Othman
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Correspondence to Mohamed O. Othman.

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Conflict of interest

Mohamed Othman is a consultant for Boston Scientific Corporation, Olympus, ConMed and Apollo. He received research grants funding from Abbvie, Kangen pharmaceutical and Lucid Diagnostics. Kalpesh Patel is a consultant for Boston Scientific Corporation and ConMed. Other authors disclosed no conflict of interests.

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Kligman, E., Ali, H., Chen, E. et al. Ethnicity Is an Important Consideration in Screening for Gastric Intestinal Metaplasia. Dig Dis Sci 67, 4509–4517 (2022). https://doi.org/10.1007/s10620-021-07326-2

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  • DOI: https://doi.org/10.1007/s10620-021-07326-2

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