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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Gastric intestinal metaplasia development in African American predominant United States population
Akram I Ahmad, Arielle Lee, Claire Caplan, Colin Wikholm, Ioannis Pothoulakis, Zaynab Almothafer, Nishtha Raval, Samantha Marshall, Ankit Mishra, Nicole Hodgins, In Guk Kang, Raymond K Chang, Zachary Dailey, Arvin Daneshmand, Anjani Kapadia, Jae Hak Oh, Brittney Rodriguez, Abhinav Sehgal, Matthew Sweeney, Christopher B Swisher, Daniel F Childers, Corinne O'Connor, Lynette M Sequeira, Won Cho
Akram I Ahmad, Ioannis Pothoulakis, Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC 20010, United States
Arielle Lee, Claire Caplan, Colin Wikholm, Zaynab Almothafer, Nishtha Raval, Samantha Marshall, Ankit Mishra, Nicole Hodgins, In Guk Kang, Raymond K Chang, Zachary Dailey, Arvin Daneshmand, Anjani Kapadia, Jae Hak Oh, Brittney Rodriguez, Abhinav Sehgal, Matthew Sweeney, Christopher B Swisher, Daniel F Childers, Corinne O'Connor, Lynette M Sequeira, Won Cho, Department of Internal Medicine, Georgetown University School of Medicine, Washington, DC 20007, United States
Won Cho, Department of Gastroenterology and Hepatology, INOVA Medical System, Leesburg, VA 20176, United States
Author contributions: Ahmad AI and Cho W contributed to the study designing and wrote the manuscript; Ahmad AI, Cho W, Lee A and Pothoulakis I contributed to the manuscript edit; Lee A, Caplan C, Wikholm C performed the project coordinator; Lee A, Caplan C, Almothafer Z, Raval N, Marshall S, Hodgins N, Kang IG, Chang RK, Dailey Z, Daneshmand A, Kapadia A, Oh JH, Rodriguez B, Sehgal A, Sweeney M, Swisher CB, Childers DF, Mishra A, O'Connor C and Sequeira LM contributed to the data collection.
Institutional review board statement: The study was reviewed and approved by the Medstar Health Research Institute and Georgetown University Hospital Institutional Review Board.
Informed consent statement: The study was exempt from informed consent based on the MedStar Health Research Institute IRB committee.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at Akram.i.ahmad@medstar.net.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Akram I Ahmad, MBBS, Doctor, Department of Internal Medicine, MedStar Washington Hospital Center, 110 Irving St NW, Washington, DC 20010, United States. akram.i.ahmad@medstar.net
Received: July 17, 2022
Peer-review started: July 17, 2022
First decision: August 19, 2022
Revised: September 1, 2022
Accepted: September 21, 2022
Article in press: September 21, 2022
Published online: October 16, 2022
ARTICLE HIGHLIGHTS
Research background
Gastric intestinal metaplasia (GIM) is a form of gastric pre-malignant lesions. It falls on the spectrum of the Correa cascade. The cascade includes chronic gastritis, atrophic gastritis, GIM, and dysplasia.
Research motivation
We designed this study to investigate factors leading to GIM formation. There is a lack of literature about this topic in the United States, especially among ethnic minorities, which are considered high-risk populations.
Research objectives
We aimed to identify factors that increase GIM formation in high-risk populations. These factors would help guide the future surveillance of selected patients and possibly suggest treatment modalities.
Research methods
This is a retrospective longitudinal study in a tertiary hospital in Washington, DC. The study includes patients with at least two upper endoscopies with gastric biopsies to assess the evolution of GIM over time. A Cox regression model was built to investigate the significant factors over the study time.
Research results
Our study confirms that Ethnicity-Race minorities have a higher rate of GIM formation. We found that gastritis increases GIM formation over time. Helicobacter pylori in low-prevalence areas might not be a strong risk factor. Our results emphasize on future surveillance of minorities and management of gastritis as a way to reduce the burden of gastric cancer.
Research conclusions
In conclusion, our study suggests that older age, having gastritis, or being from ethnic-race minorities is associated with an increased risk of GIM.
Research perspectives
Further studies are needed to clarify factors associated with GIM progression and regression. This would help form a complete picture of the development and progression of gastric pre-malignant lesions.
