Gastric Cancer Risk Increases in Patients with Precancerous Gastric Lesions

Dr. Weimin Ye, MD, PhD, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, and colleagues, have reported that the risk of developing gastric cancer increases in patients with precancerous gastric lesions. The risk of developing gastric cancer increases even more with higher severity of the lesion. Dr. Weimin Ye and team emphasized the importance of patient surveillance in this study. This study was recently published in The British Medical Journal.

Dr. Weimin Ye and team conducted a population-based cohort study through data analysis of 405,211 patients from Swedish national registers that underwent gastric biopsies between 1979 and 2011. During an average follow-up period of about 10 years excluding the first two years of follow-up, the researchers identified 1599 cases of gastric cancer diagnosed. Study results revealed that the 20-year risk of developing gastric cancer is 1 in 19 for dysplasia, 1 in 39 for those with intestinal metaplasia, 1 in 50 for patients with atrophic gastritis, 1 in 85 for those with gastritis, and 1 in 256 for patients with a normal mucosa. Using Cox regression analysis, patients are at 1.8-fold risk of developing gastric cancer in the next 20 years if there are minor changes in intestinal mucosa compared to those with healthy tissue. In patients with dysplasia, the risk increased to about 11-fold risk. Further details on the study result can be found here.

Dr. Weimin Ye and team explained that this study further strengthen the validity of Correa's cascade. This cascade is a widely accepted pathologic sequence starting with gastrointestinal mucosa infection by Helicobacter pylori which then cause the formation of gastric lesions, and ultimately the development of gastric cancer. Dr. Weimin Ye described this study as a stepping stone to determine the risks of developing gastric cancer in patients with gastric precancerous lesions. Dr. Weimin Ye believes that close monitoring of patients with more severe lesions is vital despite the workload and cost-benefit analysis needed to develop surveillance strategies for these patients.

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