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Author Spotlight: Advancing Early Detection and Treatment of Gastrointestinal Tumors
Published on: February 16, 2024
PREVALENCE OF GASTRIC CANCER AND PRENEOPLASTIC LESIONS: A CROSS-SECTIONAL STUDY IN A MEDIUM-RISK WESTERN POPULATION
Victor Cangussu Teixeira Campos1, Mayara Pezzini Arantes2, Luiz Roberto Kotze2
1Complexo Hospital de Clínicas da Universidade Federal do Paraná, Unidade de Endoscopia Digestiva, Curitiba, PR, Brasil.
Background:
The late diagnosis of gastric cancer, which is usually diagnosed via upper digestive endoscopy, may be attributed to the failure to detect precursor lesions. This study aimed to determine the prevalence of gastric cancer and its precursor lesions in individuals undergoing routine upper gastrointestinal endoscopies at a tertiary hospital in Brazil.
Methods:
Patients aged >40 years who had undergone diagnostic endoscopic examinations in 2017 at our institution were included in this retrospective cross-sectional study. We exclude patients with more than one examination in the time-period, without gastric biopsies, and those with autoimmune atrophic gastritis and history of gastric surgery. The histopathological findings were reviewed by two gastrointestinal pathologists. The Operative Link on Gastritis Assessment (OLGA) classification was used in cases wherein gastric mapping was performed. Descriptive statistical analysis for the diagnostic findings of the malignant precursor lesions and gastric cancer was performed using Chi-square test. Statistical significance was set at P<0.05.
Results:
Among the 1,071 patients (64.6% females; age 60±10.4 years old) who underwent endoscopic examinations, 277 (25.9%) were diagnosed with malignant precursor lesions or cancer, three (0.3%) dysplastic lesions, and 12 (1.1%) neoplasms. A total of 888 patients underwent gastric mapping; OLGA III and IV stages were observed in 46 (5.2%) patients. Chi-square test revealed significant correlations between dysplastic and neoplastic lesions and male sex, age >80 years and the prevalence of chronic atrophic gastritis and intestinal metaplasia, and age 40-49 years and the prevalence of Helicobacter pylori infection.
Conclusion:
Precursor lesions for gastric cancer were observed in up to 25% of the patients, with a predominance of low-risk lesions. Further prospective studies must be conducted to evaluate the risk of gastric cancer in individuals with precursor lesions and formulate prevention strategies.
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