Clinical risk assessment for gastric cancer in asymptomatic population after a health check-up

Abstract

For the prevention of gastric cancer, the detection of risk factors associated with precancerous conditions may be more informative. The aim of this study was to identify the risk factors of gastric cancer, including precancerous conditions: atrophic gastritis (AG), intestinal metaplasia (IM), and dysplasia.The clinical and endoscopic findings of 60,261 adults who underwent gastroduodenoscopy as part of a health check-up were reviewed retrospectively. Subgroup analysis was conducted according to age, sex, cancer stage, and histology based on Lauren classification.Gastric cancer was diagnosed in 75 patients (0.12%). Both IM and AG were independent risk factors for gastric cancer in all subgroups. Male, older age, obesity, diabetes mellitus (DM), a salty and spicy diet, and Helicobacter pylori (H. pylori) were significantly associated with precancerous conditions. However, risk factors related to precancerous conditions were different according to age and sex. In <40 years, H. pylori was the only risk factor related to precancerous conditions, whereas DM with a salty and spicy diet were additional risk factors in ≥40 years. In female individuals, obesity was significant risk factor for precancerous conditions as well as H. pylori infection.AG and IM are independent risk factors for gastric cancer. To prevent gastric cancer, H. pylori eradication may be more useful in <40 years, whereas additional factors such as DM, obesity, salty and spicy diet may be important in female or ≥40 years.

Global circular RNA expression profile of human gastric cancer and its clinical significance

“…). Chronic atrophic gastritis is considered as an independent risk factor for gastric cancer . People with chronic atrophic gastritis have been thought as high‐risk of gastric cancer.…”

Body Mass Index and Risk of Intestinal Metaplasia: A Cohort Study

“…In another large-scale retrospective study of 60,261 Korean adults, obesity was significantly associated with endoscopically diagnosed precancerous lesions including atrophic gastritis and intestinal metaplasia, with a multivariable adjusted OR (95% CI) of 1.10 (1.01-1.18; ref. 26). However, these previous studies are all crosssectional studies limited by the temporal ambiguity between obesity and atrophic gastritis and intestinal metaplasia.…”

“…The effect of obesity on precursor lesions such as atrophic gastritis or intestinal metaplasia has also been examined in several observational studies, but results are inconclusive. Some studies reported a positive association between BMI and atrophic gastritis or intestinal metaplasia, whereas others reported no association (21)(22)(23)(24)(25)(26)(27). However, previous studies used cross-sectional design, limiting their ability to establish the temporal relationship between obesity and atrophic gastritis or intestinal metaplasia.…”

Reversibility of atrophic gastritis and intestinal metaplasia after Helicobacter pylori eradication ‐ a prospective study for up to 10 years

“…To reduce its socioeconomic burden, strategies are needed . Risk factors of GC include Helicobacter pylori ( H. pylori ) infection, salt intake, smoking habit, alcohol consumption, male sex, low socioeconomic status, family history for GC, and existence of atrophic gastritis (AG) and intestinal metaplasia (IM) . H. pylori eradication reduces the incidence risk of GC in H. pylori infected patients .…”