Global progression rates of precursor lesions for gastric cancer: A systematic review and meta-analysis Review


Authors: Hahn, A. I.; Mülder, D. T.; Huang, R. J.; Zhou, M. J.; Blake, B.; Omofuma, O.; Murphy, J. D.; Gutiérrez-Torres, D. S.; Zauber, A. G.; O'Mahony, J. F.; Camargo, M. C.; Ladabaum, U.; Yeh, J. M.; Hur, C.; Lansdorp-Vogelaar, I.; Meester, R.; Laszkowska, M.
Review Title: Global progression rates of precursor lesions for gastric cancer: A systematic review and meta-analysis
Abstract: Background & Aims: Whether gastric cancer (GC) precursor lesions progress to invasive cancer at similar rates globally remains unknown. We conducted a systematic review and meta-analysis to determine the progression of precursor lesions to GC in countries with low versus medium/high incidence. Methods: We searched relevant databases for studies reporting the progression of endoscopically confirmed precursor lesions to GC. Studies were stratified by low (<6 per 100,000) or medium/high (≥6 per 100,000) GC incidence countries. Random-effects models were used to estimate the progression rates of atrophic gastritis (AG), intestinal metaplasia (IM), and dysplasia to GC per 1000 person-years. Results: Among the 5829 studies identified, 44 met our inclusion criteria. The global pooled estimates of the progression rate per 1000 person-years were 2.09 (95% confidence interval, 1.46–2.99), 2.89 (2.03–4.11), and 10.09 (5.23–19.49) for AG, IM, and dysplasia, respectively. The estimated progression rates per 1000 person-years for low versus medium/high GC incidence countries, respectively, were 0.97 (0.86–1.10) versus 2.47 (1.70–2.99) for AG (P < .01), 2.37 (1.43–3.92) versus 3.47 (2.13–5.65) for IM (P = .29), and 5.51 (2.92–10.39) versus 14.80 (5.87–37.28) for dysplasia (P = .08). There were no differences for progression of AG between groups when high-quality studies were compared. Conclusions: Similar progression rates of IM and dysplasia were observed among low and medium/high GC incidence countries. This suggests that the potential benefits of surveillance for these lesions in low-risk regions may be comparable with those of population-wide interventions in high-risk regions. Further prospective studies are needed to confirm these findings and inform global screening and surveillance guidelines. © 2024 AGA Institute
Keywords: progression; gastric cancer; precursor lesions; natural history
Journal Title: Clinical Gastroenterology and Hepatology
Volume: 23
Issue: 9
ISSN: 1542-3565
Publisher: Elsevier Science, Inc.  
Publication status: Published
Date Published: 2025-08-01
Online Publication Date: 2024-10-01
Start Page: 1514
End Page: 1524.e13
Language: English
DOI: 10.1016/j.cgh.2024.09.003
PUBMED: 39362617
PROVIDER: scopus
PMCID: PMC11958785
DOI/URL:
Notes: Review -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Anne Hahn -- Source: Scopus
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MSK Authors
  1. Ann G Zauber
    316 Zauber
  2. Anne Impellizeri Hahn
    19 Hahn