PRE-MALIGNANT GASTRIC LESIONS IN THE NETHERLANDS

Gastric cancer is the fourth most common cancer and second leading cause of cancer-related deaths worldwide. The pre-malignant gastric lesions, atrophic gastritis, intestinal metaplasia and dysplasia, have long been identified as principal risk factors for gastric cancer. However, a study to evaluate epidemiological time trends of pre-malignant gastric lesions in The Netherlands found that the incidence is declining. Patients with a first diagnosis of atrophic gastritis, intestinal metaplasia or dysplasia between 1991 and 2005 were identified in the Dutch nationwide histopathology registry. The median age at diagnosis was 65.7 years. In all, 23 278 patients were newly diagnosed with atrophic gastritis, 65 937 with intestinal metaplasia and 8517 with dysplasia. The incidence of atrophic gastritis declined similarly in men and women with 8.2% per year, and dysplasia with 8.1% per year. Significantly more females were present in the atrophic gastritis group (male/female 1.0/1.2) compared with the group of patients with intestinal metaplasia (1.0/0.9) or dysplasia (1.0/0.8). The proportional number of new intestinal metaplasia cases declined, with 2.9% per year in males and 2.4% in females. These findings imply that a further decrease of at least 24% in the incidence of …