Clinical epidemiology and outcomes of patients with gastric intestinal metaplasia in the Los Angeles County System
Abstract Background Gastric intestinal metaplasia (GIM) is a precursor to gastric adenocarcinoma (GAC). In the United States, there is no consensus on the utility of surveillance for GIM, and minority populations most affected by GAC are understudied. Our aims were to define clinical and endoscopic...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-023-02797-1 |
| _version_ | 1797822780990816256 |
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| author | Preeti Prakash Shailavi Jain Harry Trieu Kenneth Chow Deepthi Karunasiri Tom Liang Evan Yung Holli Mason Hongying Tan James H. Tabibian |
| author_facet | Preeti Prakash Shailavi Jain Harry Trieu Kenneth Chow Deepthi Karunasiri Tom Liang Evan Yung Holli Mason Hongying Tan James H. Tabibian |
| author_sort | Preeti Prakash |
| collection | DOAJ |
| description | Abstract Background Gastric intestinal metaplasia (GIM) is a precursor to gastric adenocarcinoma (GAC). In the United States, there is no consensus on the utility of surveillance for GIM, and minority populations most affected by GAC are understudied. Our aims were to define clinical and endoscopic features, surveillance practices, and outcomes in patients with GIM in a multicenter safety-net system. Methods We identified patients with biopsy-proven GIM between 2016–2020 at the three medical centers comprising Los Angeles County Department of Health Services. Demographics, findings at index esophagogastroduodenoscopy (EGD) first showing GIM, recommended interval for repeat EGD, and findings at repeat EGD were abstracted. Descriptive statistics were performed to characterize our cohort. T-tests and chi-squared (χ2) tests were used to compare patients with and without multifocal GIM. Results There were 342 patients with newly-diagnosed biopsy-proven GIM, 18 (5.2%) of whom had GAC at index EGD. Hispanic patients comprised 71.8% of patients. For most patients (59%), repeat EGD was not recommended. If recommended, 2–3 years was the most common interval. During a median time to repeat EGD of 13 months and cumulative follow-up of 119 patient-years, 29.5% of patients underwent at least one repeat EGD, of whom 14% had multifocal GIM not previously detected. Progression to dysplasia or GAC was not detected in any patients. Conclusion In a predominantly minority population with biopsy-proven GIM, there was a 5% incidence of GAC on index EGD. Though progression to neither dysplasia nor GAC was detected, there was significant variability in endoscopic sampling and surveillance practices. |
| first_indexed | 2024-03-13T10:14:14Z |
| format | Article |
| id | doaj.art-0dbfa0f6a9cf4eeda7cd58a0bda5d86a |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-03-13T10:14:14Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-0dbfa0f6a9cf4eeda7cd58a0bda5d86a2023-05-21T11:17:47ZengBMCBMC Gastroenterology1471-230X2023-05-012311810.1186/s12876-023-02797-1Clinical epidemiology and outcomes of patients with gastric intestinal metaplasia in the Los Angeles County SystemPreeti Prakash0Shailavi Jain1Harry Trieu2Kenneth Chow3Deepthi Karunasiri4Tom Liang5Evan Yung6Holli Mason7Hongying Tan8James H. Tabibian9David Geffen School of Medicine at the University of California Los Angeles (UCLA)David Geffen School of Medicine at the University of California Los Angeles (UCLA)Keck School of Medicine at the University of Southern CaliforniaDepartment of Medicine, Harbor-UCLA Medical CenterDepartment of Pathology, Olive-View-UCLA Medical CenterDepartment of Pathology, Los Angeles County-University of Southern California Medical CenterDepartment of Pathology, Los Angeles County-University of Southern California Medical CenterDepartment of Pathology, Harbor-UCLA Medical CenterDepartment of Pathology, Olive-View-UCLA Medical CenterDavid Geffen School of Medicine at the University of California Los Angeles (UCLA)Abstract Background Gastric intestinal metaplasia (GIM) is a precursor to gastric adenocarcinoma (GAC). In the United States, there is no consensus on the utility of surveillance for GIM, and minority populations most affected by GAC are understudied. Our aims were to define clinical and endoscopic features, surveillance practices, and outcomes in patients with GIM in a multicenter safety-net system. Methods We identified patients with biopsy-proven GIM between 2016–2020 at the three medical centers comprising Los Angeles County Department of Health Services. Demographics, findings at index esophagogastroduodenoscopy (EGD) first showing GIM, recommended interval for repeat EGD, and findings at repeat EGD were abstracted. Descriptive statistics were performed to characterize our cohort. T-tests and chi-squared (χ2) tests were used to compare patients with and without multifocal GIM. Results There were 342 patients with newly-diagnosed biopsy-proven GIM, 18 (5.2%) of whom had GAC at index EGD. Hispanic patients comprised 71.8% of patients. For most patients (59%), repeat EGD was not recommended. If recommended, 2–3 years was the most common interval. During a median time to repeat EGD of 13 months and cumulative follow-up of 119 patient-years, 29.5% of patients underwent at least one repeat EGD, of whom 14% had multifocal GIM not previously detected. Progression to dysplasia or GAC was not detected in any patients. Conclusion In a predominantly minority population with biopsy-proven GIM, there was a 5% incidence of GAC on index EGD. Though progression to neither dysplasia nor GAC was detected, there was significant variability in endoscopic sampling and surveillance practices.https://doi.org/10.1186/s12876-023-02797-1EndoscopyGastric cancerSurveillanceRisk FactorsDisparities, Healthcare |
| spellingShingle | Preeti Prakash Shailavi Jain Harry Trieu Kenneth Chow Deepthi Karunasiri Tom Liang Evan Yung Holli Mason Hongying Tan James H. Tabibian Clinical epidemiology and outcomes of patients with gastric intestinal metaplasia in the Los Angeles County System BMC Gastroenterology Endoscopy Gastric cancer Surveillance Risk Factors Disparities, Healthcare |
| title | Clinical epidemiology and outcomes of patients with gastric intestinal metaplasia in the Los Angeles County System |
| title_full | Clinical epidemiology and outcomes of patients with gastric intestinal metaplasia in the Los Angeles County System |
| title_fullStr | Clinical epidemiology and outcomes of patients with gastric intestinal metaplasia in the Los Angeles County System |
| title_full_unstemmed | Clinical epidemiology and outcomes of patients with gastric intestinal metaplasia in the Los Angeles County System |
| title_short | Clinical epidemiology and outcomes of patients with gastric intestinal metaplasia in the Los Angeles County System |
| title_sort | clinical epidemiology and outcomes of patients with gastric intestinal metaplasia in the los angeles county system |
| topic | Endoscopy Gastric cancer Surveillance Risk Factors Disparities, Healthcare |
| url | https://doi.org/10.1186/s12876-023-02797-1 |
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