Changing Trends in Gastric Polyps

Rev Invest Clin. 2018;70(1):40-45. doi: 10.24875/RIC.17002430.

Abstract

Background: The prevalence of gastric polyps varies around the world reflecting regional associations. We describe demographic features of patients with gastric polyp diagnosis treated between 1980 and 2016 at a referral center in Mexico City and analyzed trends of polyp subtype.

Materials and methods: We conducted a blind review of archival slides of gastric biopsies with polyp diagnosis from the years 1980, 1990, 2000, 2010, and 2016. Initial diagnosis; patient's gender, age and symptoms; and number and location of lesions were recorded. Blind slide review and trend analysis were performed.

Results: In 3887 gastric biopsies, 192 patients (4.93%) with epithelial polyps were identified. The median age of patients was 58 years; 73% were female. Polyps were single in 143/192 cases (74.4%), almost 67% in the oxyntic mucosa, and 85% were associated with dyspepsia. The prevalence was 0.5%, 1.6%, 1.9%, 4.6%, and 9.6% for the years 1980, 1990, 2000, 2010, and 2016, respectively, resulting in a rising trend in the prevalence of epithelial polyps of 380% in 46 years. Fundic gland polyps (FGPs) had a global frequency of 66.6% (128/192). They were identified for the first time in the third period of the study, with a frequency of 28.6% (6/21), 66.6% (35/53), and 78.3% (87/111) for the years 2000, 2010, and 2016, respectively. Contrary, hyperplastic polyps (HPs) decreased 20%. A relative prevalence of 3.29%, 0.97%, and 0.15% was observed for FGP, HP, and gastric adenoma, respectively.

Discussion: The 1400% change of FGP explains the increased prevalence of gastric polyps. Chronic treatment with proton pump inhibitors and Helicobacter pylori eradication are possible explanations.

Keywords: Fundic gland polyp; Gastric adenoma; Gastric polyp; Hyperplastic polyp; Mexico; Prevalence; Time trend.

MeSH terms

  • Adenoma / diagnosis
  • Adenoma / epidemiology*
  • Adenoma / pathology
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Dyspepsia / epidemiology
  • Dyspepsia / etiology
  • Female
  • Gastric Fundus / pathology*
  • Humans
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • Polyps / diagnosis
  • Polyps / epidemiology*
  • Polyps / pathology
  • Prevalence
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / epidemiology*
  • Stomach Neoplasms / pathology
  • Young Adult