title: Occurrence of gastric cancer and carcinoids in atrophic gastritis during prospective long-term follow up.
abstract: OBJECTIVE
  Atrophic gastritis (AG) is a risk condition for gastric cancer and type I gastric carcinoids. Recent studies assessing the overall risk of gastric cancer and carcinoids in AG at long-term follow up are lacking. This study aimed to investigate in a prospective cohort of AG patients the occurrence of gastric cancer and carcinoids at long-term follow up.
  
  
  METHODS
  A total of 200 AG patients from a prospective cohort (67% female, median age 55 years) with a follow up of 7.5 (range: 4-23.4) years were included. Inclusion criteria were presence of AG and at least one follow-up gastroscopy with biopsies at ≥4 years after AG diagnosis. Follow-up gastroscopies at 4-year intervals were performed.
  
  
  RESULTS
  Overall, 22 gastric neoplastic lesions were detected (crude incidence 11%). Gastric cancer was diagnosed in four patients at a median follow up of 7.2 years (crude incidence 2%). Eleven type I gastric carcinoids were detected at a median follow up of 5.1 years (crude incidence of 5.5%). In seven patients, six low-grade and one high-grade dysplasia were found. The annual incidence rate person-year were 0.25% (95% confidence interval [CI]: 0.067-0.63%), 0.43% (95% CI: 0.17-0.89%), and 0.68% (95% CI: 0.34-1.21%) for gastric cancer, dysplasia, and type I-gastric carcinoids, respectively. The incidence rates of gastric cancer and carcinoids were not different (p = 0.07).
  
  
  CONCLUSIONS
  This study shows an annual incidence rate of 1.36% person-year for gastric neoplastic lesions in AG patients at long-term follow up. AG patients are similarly exposed to gastric cancer and type I gastric carcinoids.
authors: Department of Digestive and Liver Disease, Sant'Andrea Hospital, Sapienza University Rome , Rome , Italy.
authors: Edith
authors: E
authors: Lahner
authors: Gianluca
authors: G
authors: Esposito
authors: Emanuela
authors: E
authors: Pilozzi
authors: Flaminia
authors: F
authors: Purchiaroni
authors: Vito D
authors: VD
authors: Corleto
authors: Emilio
authors: E
authors: Di Giulio
authors: Bruno
authors: B
authors: Annibale
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002276:Carcinoid Tumor / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D005757:Gastritis, Atrophic / Q000473:pathology*; D005773:Gastroscopy; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D012044:Regression Analysis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology*; D055815:Young Adult
keywords: atrophic gastritis; follow up; gastric cancer; pernicious anemia; type I gastric carcinoids