P5063 - Risk Factors for Intestinal Metaplasia Development and Progression: A Systematic Review

Justin Tin, ¹, Zaki Masoud, MD², Ibrahim Mukadam, MBBS³, Aparna Krishnan, MBBS⁴, Anuj Bhalla, MBBS⁵, Kunal Singh, MBBS⁶, Kevin Tin, MD, MBA^3
1Newtown Gastroenterology, Flushing, NY; ²New York University Langone Health, Albertson, NY; ³Newtown Gastroenterology, New York, NY; ⁴Lady Hardinge Medical College, New Delhi, Delhi, India; ⁵Dayanand Medical College and Hospital, Elmhurst, NY; ⁶Jawaharlal Nehru Medical College, Jersey City, NJ

Introduction: Intestinal metaplasia (IM) has been established as a significant risk factor for gastric cancer (GC). Understanding the
risk factors for the development and progression of IM is critical for identifying high-risk
individuals and implementing preventive interventions for gastric cancer. This systematic review aims to examine the current literature on the risk factors associated with IM and to evaluate their impact on the development and progression of
this condition.

Methods: A systematic literature search was conducted on PubMed, Scopus, and ScienceDirect databases,
for articles published from database inception to 1 st June 2023. The identified articles were then
subjected to a study selection process. Thematic analysis was employed to examine how each
risk factor (as a theme) affected IM incidence and progression.

Results: The initial search identified 2655 articles from databases and only 28 articles were included in
this systematic review. The significant risk factors for IM incidence are H. pylori infection, older age, male gender,
higher BMI, active smoking, consumption of spicy food and being of an African-American
ethnicity. Some of the risk factors that did not reach statistical significance are, having a smoking
history, GERD, having a family history of GC, diabetic mellitus, hypertension,
consumption of salty foods, and consumption of dairy products. Some of the risk factors for IM
progression are older age, H.pyori infection, male gender, smoking and alcohol consumption. Being a relative to a GC patient did not reach statistical significance as a risk factor for
IM progression. Being older ( > 50 years, especially those > 60 years) and being male were
significantly liked to the severity of IM. This review also reports some protective factors like
consumption of soft drinks, fruits and vegetables and having duodenal ulcer illness.

Discussion: People who have H.pylori infection, are older, are male in gender, are active smokers and
consume alcohol are at substantial risk for both IM incidence and progression. Also, people who
have a smoking history, consume spicy foods, consume salty foods, have a family history of
GC, have higher BMI, or have GERD are also at risk. This review calls for
consideration of these cohorts as high-risk populations when formulating IM and GC
intervention measures.



Disclosures:


Justin Tin, ¹, Zaki Masoud, MD², Ibrahim Mukadam, MBBS³, Aparna Krishnan, MBBS⁴, Anuj Bhalla, MBBS⁵, Kunal Singh, MBBS⁶, Kevin Tin, MD, MBA³. P5063 - Risk Factors for Intestinal Metaplasia Development and Progression: A Systematic Review, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.