Fortunately, the rate of progression to the development of gastric cancer (GC) is pretty rare among patients in the US. However, an article released this week (Reddy KM et al., Clin Gastroenterol Hepatol 2016 Jun 15) outlines the added risk that family history and extensive gastrointestinal metaplasia contribute to the development of GC. I am writing on this because we know that the identification of gastric intestinal metaplasia (GIM) in the stomach can be a significant precursor to the development of GC. So, what is GIC exactly? When a patient has an increase in acid in their stomach and esophagus secondary to increased production caused by Helicobacter pylori (for example), the mucosa of the epithelium that lines the esophagus can actually change from the normal squamous cells to cells that contain mucous producing properties, known as goblet cells. This change in type is known as ‘metaplasia,’ and it IS reversible. The bad news is that if the metaplasia is left unchecked, it may progress to dysplasia, which is an IRREVERSIBLE change to a pre-cancerous state. A progression to significant dysplasia indicates that the area could need removal to prevent the development of cancer. The best way to guard against these dangerous changes and avoid the development of cancer is to avoid known cancer causing stimuli, such as smoking, or irritants such as alcohol. The development of metaplasia is usually not accompanied by many easily identified symptoms for the patient, so regular checkups with a qualified medical practitioner are crucial for populations at risk, and even more so if IM has been identified.
For more information: http://www.cghjournal.org/article/S1542-3565(16)30314-7/pdf