Abstract
Background
The prevalence of H. pylori infection and the incidence of gastric cancer differ widely around the world, but it is unclear whether these differences are mirrored in the multiethnic population of the USA.
Aims
This study tested the hypothesis that the prevalence of both H. pylori infection and gastric preneoplastic lesions in US residents of Hispanic and Asian ancestry reflects the incidence of gastric cancer in their ancestral countries.
Methods
A total of 799,075 subjects with gastric biopsies extracted from a national pathology database were stratified into the following ancestries: Indian, Hispanic, Vietnamese, Chinese, Japanese Korean, and other Americans (Caucasian and African-American US residents). The prevalence of H. pylori, intestinal metaplasia, and atrophic gastritis was compared among different ethnic groups using age- and sex-adjusted odds ratios and linear regression.
Results
Patients of Indian, Hispanic, Vietnamese, Chinese, Japanese, and Korean ancestry had significantly higher prevalence rates of H. pylori gastritis, intestinal metaplasia, and atrophy than other Americans. The prevalence of intestinal metaplasia and atrophy among different ethnic groups did not correlate with H. pylori prevalence, but did correlate highly significantly with gastric cancer incidence in the patients’ ancestral countries.
Conclusions
Various US ethnic groups have significantly different prevalence rates of H. pylori gastritis and gastric preneoplastic lesions. Patients’ ethnicity needs be considered in the prevention and early detection of gastric cancer.
Similar content being viewed by others
References
Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No 11. 2013. http://globocan.iarc.fr/Pages/fact_sheets_population.aspx. Accessed August 24, 2014.
Correa P, Haenszel W, Cuello C, et al. Gastric precancerous process in a high risk population: cohort follow-up. Cancer Res. 1990;50:4737–4740.
Asaka M, Sugiyama T, Nobuta A, et al. Atrophic gastritis and intestinal metaplasia in Japan: results of a large multicenter study. Helicobacter. 2001;6:294–299.
You WC, Li JY, Blot WJ, et al. Evolution of precancerous lesions in a rural Chinese population at high risk of gastric cancer. Int J Cancer. 1999;83:615–619.
You WC, Zhang L, Gail MH, et al. Precancerous lesions in two counties of China with contrasting gastric cancer risk. Int J Epidemiol. 1998;27:945–948.
Kim N, Park RY, Cho SI, et al. Helicobacter pylori infection and development of gastric cancer in Korea: long-term follow-up. J Clin Gastroenterol. 2008;42:448–454.
Fennerty MB, Emerson JC, Sampliner RE, et al. Gastric intestinal metaplasia in ethnic groups in the southwestern United States. Cancer Epidemiol Biomarkers Prev. 1992;1:293–296.
El-Omar EM, Oien K, Murray LS, et al. Increased prevalence of precancerous changes in relatives of gastric cancer patients: critical role of H. pylori. Gastroenterology. 2000;118:22–30.
Farinati F, Valiante F, Germana B, et al. Prevalence of Helicobacter pylori infection in patients with precancerous changes and gastric cancer. Eur J Cancer Prev. 1993;2:321–326.
Rugge M, Cassaro M, Farinati F, et al. Helicobacter pylori and atrophic gastritis: importance of the cagA status. J Natl Cancer Inst. 1996;88:762–763.
US Census Bureau. United States Census Bureau—Foreign Born. 2014. http://www.usa.gov/directory/federal/bureau-of-the-census.shtml. Accessed: August 24, 2014.
Castillo RJ, Guo KL. A framework for cultural competence in health care organizations. Health Care Manag (Frederick). 2011;30:205–214.
Phillips JM, Malone B. Increasing racial/ethnic diversity in nursing to reduce health disparities and achieve health equity. Public Health Rep. 2014;129:45–50.
Polacek GN, Martinez R. Assessing cultural competence at a local hospital system in the United States. Health Care Manag (Frederick). 2009;28:98–110.
Like RC. Culturally competent managed health care: a family physician’s perspective. J Transcult Nurs. 1999;10:288–289.
Sonnenberg A, Lash RH, Genta RM. A national study of Helicobactor pylori infection in gastric biopsy specimens. Gastroenterology. 2010;139:1894–1901.
Malhotra R, Turner K, Sonnenberg A, Genta RM. High prevalence of inflammatory bowel disease in United States Residents of Indian Ancestry. Clin Gastroenterol Hepatol. 2014;S1542–3565(14)01090–01098. [Epub ahead of print].
Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol. 1996;20:1161–1181.
Rugge M, Correa P, Dixon MF, et al. Gastric mucosal atrophy: interobserver consistency using new criteria for classification and grading. Aliment Pharmacol Ther. 2002;16:1249–1259.
Rugge M, Correa P, Di Mario F, et al. OLGA staging for gastritis: a tutorial. Dig Liver Dis. 2008;40:650–658.
Rugge M, Pennelli G, Giacomelli L, et al. Gastritis OLGA-staging and gastric cancer risk: a twelve-year clinico-pathological follow-up study. Aliment Pharmacol Ther. 2010;31:1104–1111.
Capelle LG, de Vries AC, Haringsma J, et al. The staging of gastritis with the OLGA system by using intestinal metaplasia as an accurate alternative for atrophic gastritis. Gastrointest Endosc. 2010;71:1150–1158.
Isajevs S, Liepniece-Karele I, Janciauskas D, et al. Gastritis staging: interobserver agreement by applying OLGA and OLGIM systems. Virchows Arch. 2014;464:403–407.
Genta RM. Differential diagnosis of reactive gastropathy. Semin Diagn Pathol. 2005;22:273–283.
Lash JG, Genta RM. Adherence to the Sydney System guidelines increases the detection of Helicobacter gastritis and intestinal metaplasia in 400738 sets of gastric biopsies. Aliment Pharmacol Ther. 2013;38:424–431.
Griffith DM, Johnson J, Ellis KR, Schulz AJ. Cultural context and a critical approach to eliminating health disparities. Ethn Dis. 2010;20:71–76.
Kerkhof M, van Dekken H, Steyerberg EW, et al. Grading of dysplasia in Barrett’s oesophagus: substantial interobserver variation between general and gastrointestinal pathologists. Histopathology. 2007;50:920–927.
Dixon MF, Brown LJ, Gilmour HM, et al. Observer variation in the assessment of dysplasia in ulcerative colitis. Histopathology. 1988;13:385–397.
Preti M, Mezzetti M, Robertson C, Sideri M. Inter-observer variation in histopathological diagnosis and grading of vulvar intraepithelial neoplasia: results of an European collaborative study. BJOG. 2000;107:594–599.
Nobre AB, Pineiro-Maceira J, Luiz RR. Analysis of interobserver reproducibility in grading histological patterns of dysplastic nevi. An Bras Dermatol. 2013;88:23–31.
El-Zimaity HM, Graham DY, Al-Assi MT, et al. Interobserver variation in the histopathological assessment of Helicobacter pylori gastritis. Hum Pathol. 1996;27:35–41.
Aydin O, Egilmez R, Karabacak T, Kanik A. Interobserver variation in histopathological assessment of Helicobacter pylori gastritis. World J Gastroenterol. 2003;9:2232–2235.
Ruiz B, Garay J, Johnson W, et al. Morphometric assessment of gastric antral atrophy: comparison with visual evaluation. Histopathology. 2001;39:235–242.
Graham DY, Shiotani A. The time to eradicate gastric cancer is now. Gut. 2005;54:735–738.
Correa P, Piazuelo MB, Camargo MC. Etiopathogenesis of gastric cancer. Scand J Surg. 2006;95:218–224.
Correa P, Piazuelo MB. The gastric precancerous cascade. J Dig Dis. 2012;13:2–9.
Marcos-Pinto R, Carneiro F, Dinis-Ribeiro M, et al. First-degree relatives of patients with early-onset gastric carcinoma show even at young ages a high prevalence of advanced OLGA/OLGIM stages and dysplasia. Aliment Pharmacol Ther. 2012;35:1451–1459.
Satoh K, Osawa H, Yoshizawa M, et al. Assessment of atrophic gastritis using the OLGA system. Helicobacter. 2008;13:225–229.
Conflict of interest
Kevin Turner and Robert Genta are employees of Miraca Life Sciences. Christie Choi and Amnon Sonnenberg declare no relevant conflicts.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Choi, C.E., Sonnenberg, A., Turner, K. et al. High Prevalence of Gastric Preneoplastic Lesions in East Asians and Hispanics in the USA. Dig Dis Sci 60, 2070–2076 (2015). https://doi.org/10.1007/s10620-015-3591-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10620-015-3591-2