{Reference Type}: Journal Article
{Title}: Risk of Gastric Adenocarcinoma in a Multiethnic Population Undergoing Routine Care: An Electronic Health Records Cohort Study.
{Author}: Huang RJ;Huang ES;Mudiganti S;Chen T;Martinez MC;Ramrakhiani S;Han SS;Hwang JH;Palaniappan LP;Liang SY;
{Journal}: Cancer Epidemiol Biomarkers Prev
{Volume}: 33
{Issue}: 4
{Year}: 2024 Apr 3
{Factor}: 4.09
{DOI}: 10.1158/1055-9965.EPI-23-1200
{Abstract}: <B>UNASSIGNED: </B>Gastric adenocarcinoma (GAC) is often diagnosed at advanced stages and portends a poor prognosis. We hypothesized that electronic health records (EHR) could be leveraged to identify individuals at highest risk for GAC from the population seeking routine care.<BR><B>UNASSIGNED: </B>This was a retrospective cohort study, with endpoint of GAC incidence as ascertained through linkage to an institutional tumor registry. We utilized 2010 to 2020 data from the Palo Alto Medical Foundation, a large multispecialty practice serving Northern California. The analytic cohort comprised individuals ages 40-75 receiving regular ambulatory care. Variables collected included demographic, medical, pharmaceutical, social, and familial data. Electronic phenotyping was based on rule-based methods.<BR><B>UNASSIGNED: </B>The cohort comprised 316,044 individuals and approximately 2 million person-years (p-y) of observation. 157 incident GACs occurred (incidence 7.9 per 100,000 p-y), of which 102 were non-cardia GACs (incidence 5.1 per 100,000 p-y). In multivariable analysis, male sex [HR: 2.2, 95% confidence interval (CI): 1.6-3.1], older age, Asian race (HR: 2.5, 95% CI: 1.7-3.7), Hispanic ethnicity (HR: 1.9, 95% CI: 1.1-3.3), atrophic gastritis (HR: 4.6, 95% CI: 2.2-9.3), and anemia (HR: 1.9, 95% CI: 1.3-2.6) were associated with GAC risk; use of NSAID was inversely associated (HR: 0.3, 95% CI: 0.2-0.5). Older age, Asian race, Hispanic ethnicity, atrophic gastritis, and anemia were associated with non-cardia GAC.<BR><B>UNASSIGNED: </B>Routine EHR data can stratify the general population for GAC risk.<BR><B>UNASSIGNED: </B>Such methods may help triage populations for targeted screening efforts, such as upper endoscopy.