1. Prevalence of gastric cancer and premalignant changes in a Michigan cohort, 2013-2017
- Author
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Ling Wang, Shilpa Tatineni, Ikponmwosa Enofe, Divyesh Reddy Nemakayala, and Heather Laird-Fick
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Cancer Research ,business.industry ,Incidence (epidemiology) ,Ethnic group ,Cancer ,medicine.disease ,Race (biology) ,Oncology ,Cohort ,Medicine ,Risk factor ,business ,Socioeconomic status ,Demography - Abstract
e15539 Background: Gastric cancer (GC) is uncommon in the US. Incidence varies by geography, race/ethnicity, sex, age, and socioeconomic status (SES). H. pylori is a risk factor for premalignant lesions and GC. Prior studies estimate risk of progression from premalignant to GC at 0.1-0.5% per year. US prevalence of premalignant lesions is unclear. This study describes the prevalence of premalignant lesions and GC in a large community-based sample. Methods: Patients aged ≥18 years undergoing EGD with gastric biopsy in Sparrow Health System were identified. Pathology reports were abstracted for sociodemographics, procedure information, and pathologic findings. Only patients with complete data were included for analysis. Statistical comparisons were assessed by chi-square tests or Fisher’s exact test in contingency tables for categorical variables, or t-tests for continuous variables as appropriate. Results: 4,111 patients were included for analysis. 3,783 (92.04%) had benign findings, 119 (2.90%) premalignant changes, and 31 (0.75%) gastric malignancies. 177 (4.31%) were H. pylori positive. Patients with benign (72.2%), premalignant (69.8%) and H. pylori-positive (69.5%) findings were often inpatients ( p< 0.001 for all comparisons), but not patients with GC (58%, p= 0.37). Benign findings and H. pylori were more common in females (69.3%, p< 0.001 and 59.9%, p< 0.001, respectively). There were no sex differences for premalignant or malignant lesions. Patients with premalignancy and malignancy were older than those with benign findings (mean age 61.6 (SD = 14.8) vs 54.9 (SD = 16.1) years, p< 0.001, and 69.9 (SD = 14.2) vs 54.9 (SD = 16.1) years, p< 0.001, respectively). There was no age difference between patients with benign changes or H. pylori (mean age 54.9 (SD = 16.1) vs 56.4 (SD = 14.4) years, p= 0.24). There were no differences in SES by histological subtype. Conclusions: In a community sample, premalignant lesions and GC were uncommon and did not vary by sex or income. H. pylori infection was also uncommon and varied by sex. This may reflect actual burden of infection or protocols for testing biopsy specimens. Understanding local prevalence of premalignant changes could inform resource planning and surveillance strategies. more...
- Published
- 2019
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