P1212 - Different Biopsy Patterns for Patients of Different Ethnicity in the US

Cristian Robiou, MD¹, Anuradha Singhal, MBBS¹, Kevin Turner, DO², Robert M. Genta, MD^3
1Inform Dx - Fulgent, Irving, TX; ²University of Minnesota, Minneapolis, MN; ³Baylor College of Medicine, Irving, TX

Introduction: The incidence of gastric carcinoma (GC) varies in different parts of the world; members of high-risk populations who immigrate to other countries carry the ancestral risk, which takes generations to equalize with that of the adopted country. In the US, persons of Hispanic and East Asian ethnicity are at increased risk for GC (Choi et al, Dig Dis Sci, 2015). This study was designed to explore whether US gastroenterologists implement biopsy protocols aimed at detecting preneoplastic lesions in patients who may have ethnically related greater CG risk.

Methods: We analyzed the reported location of biopsies from all patients who had EGD with gastric biopsies diagnosed at Inform Diagnostics (1/2009 - 9/2022). Records stored in IDEA (Inform Diagnostics Electronic Archives) contain all histopathologic diagnoses tagged with searchable codes, demographic information, indications for EGD, and a summary of the endoscopic procedure. We then stratified patients by ethnicity (Hispanic; East Asian; South Asian; Other Americans) and determined the frequency with which antrum, corpus, and incisura angularis were sampled in patients from each ethnic group. Statistical significance of differences was evaluated by the Odds Ratios and their 95% confidence Intervals (OR; 95% CI).

Results: There were 2,036,113 subjects with gastric biopsies (median age 58 years; range 0–104; 61.1% female). Table 1 depicts numbers and percentage of biopsies from antrum, corpus, and incisura taken from patients stratified by ethnic group. The yield for IM is depicted for each gastric compartment. Compared to persons of other ethnicities, subjects of East Asian ancestry were less likely to have biopsies only from either antrum (OR .59; 95% CI 0.58 – 0.60) or corpus (OR .58; 95% CI 0.56 – 0.60), and >3X more likely to have biopsies from the incisura (OR 3.21; 95% CI 3.01 – 3.43). IM was detected in corpus biopsies 3X as often as in other ethnicities (OR 3.34; 95% CI 3.05 – 3.66), and in the incisura >8X (OR 8.56; 95% CI 7.42 – 9.87).

Discussion: East Asian ancestry in the US is associated with a greater risk for GC than any other ethnicity, in parallel with the high GC incidence in the ancestral countries. Although there appears to be a weak tendency to take more extensive mucosal sampling from these patients, given the much higher prevalence of preneoplastic lesions detected, greater awareness of this group's high risk and better targeted biopsy protocols should be recommended.



Disclosures:


Cristian Robiou, MD¹, Anuradha Singhal, MBBS¹, Kevin Turner, DO², Robert M. Genta, MD³. P1212 - Different Biopsy Patterns for Patients of Different Ethnicity in the US, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.