High Prevalence of Gastric Preneoplastic Lesions in East Asians and Hispanics in the USA

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.