The changing histological pattern of gastric polyps in an ethnically heterogeneous population

Abstract

Background and aim: Variation in the prevalence of various types of gastric polyps worldwide may reflect different etiologies. Here, the authors report the dynamic changes in histological distribution of gastric polyps over time and by ethnicity for individuals who underwent gastroscopies between 1994 and 2009 at two hospitals in Jerusalem, Israel. During this time period, the proportion of patients receiving proton pump inhibitors (PPIs) increased while the proportion of patients infected with Helicobacter pylori (H. pylori) decreased. Patients and methods: Pathological reports of biopsies from 50,071 consecutive gastroscopies were reviewed. Results. Gastric polyps were detected in 727 individuals. The yearly prevalence of gastric polyps was ≤1% between 1994 and 2001 and ≥2% from 2004 to 2009, of which overall 66% were hyperplastic polyps and 23% fundic gland polyps (FGPs). FGPs were diagnosed exclusively in the Jewish population. From 2001 to 2004, an increase in the absolute number of newly discovered hyperplastic and FGPs per year was observed. However from 2005, a divergent trend of changes was observed: While the proportion of patients with hyperplastic polyps dropped from 0.72 during the 2001–2004 period to 0.62 during the 2005–2009 period (p = 0.02), the proportion of patients with FGPs at these time periods increased from 0.16 to 0.33 (p = 0.0001). Conclusions. The yearly prevalence of gastric polyps in Jerusalem has recently doubled. This occurred mainly due to the increasing prevalence of FGPs. The changing epidemiology of gastric polyps is probably related to the interaction between genetic factors and fluctuating environmental factors like H. pylori infection rates and exposure to PPIs.

Key Words::

• fundic gland polyp
• helicobacter pylori
• hyperplastic polyp
• proton pump inhibitor

Acknowledgment

The authors would like to thank Professor Ora Paltiel from the Clinical Epidemiology Research Center, Department of Hematology and School of Public Health, Hadassah-Hebrew University for her critical review of the manuscript.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.