--- title: "Risk of Gastric Adenocarcinoma Undergoing Routine Care | Sutter Health" description: "Risk of Gastric Adenocarcinoma in a Multiethnic Population Undergoing Routine Care: An Electronic Health Records Cohort Study" url: "https://www.sutterhealth.org/research/publications/risk-of-gastric-adenocarcinoma-undergoing-routine-care-1055312622" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Risk of Gastric Adenocarcinoma Undergoing Routine Care # Risk of Gastric Adenocarcinoma in a Multiethnic Population Undergoing Routine Care: An Electronic Health Records Cohort Study _Cancer Epidemiology Biomarkers Prevention_ 2024-01-12 ## Abstract 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.Methods: This was a retrospective cohort study, with endpoint of GAC incidence as ascertained through linkage to an institutional tumor registry. We utilized 2010–2020 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. Results: 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. Conclusions: Routine EHR data can stratify the general population for GAC risk. Impact: Such methods may help triage populations for targeted screening efforts, such as upper endoscopy. [PubMed abstract](https://doi.org/10.1158/1055-9965.EPI-23-1200) ![Edward S Huang, M.D., MPH](https://dyn.mktgcdn.com/p/urJ-Pevi-NjWFjGs3xTjROq3wApKL9wil84gpTHKn6w/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Edward S Huang, M.D., MPH Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/edward-s-huang-md-mph-1049681054) ![Su-Ying Liang, Ph.D.](https://dyn.mktgcdn.com/p/cRIUee_GK3HEL1Wq8svqoUApvABjlwVVA-KUHVGzuNw/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Su-Ying Liang, Ph.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/su-ying-liang-phd-1049681030) ## Research topics - [Colorectal Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Colorectal+Cancer%5C%22%22) - [Gastrointestinal Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Gastrointestinal+Cancer%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [A new stochastic and state space model of human colon cancer incorporating multiple pathways.](https://www.sutterhealth.org/research/publications/new-stochastic-and-state-space-model-of-human-colon-cancer-1055312781) Tan WY, Yan XW. Biol Direct. 5:26. doi: 10.1186/1745-6150-5-26. 2010 Apr 20 - Publication ### [Implementing universal Lynch syndrome screening (IMPULSS): protocol for a multi-site study to identify strategies to implement, adapt, and sustain genomic medicine programs in different organizational contexts.](https://www.sutterhealth.org/research/publications/implementing-universal-lynch-syndrome-screening-impulss-1055312375) Rahm AK, Cragun D, Hunter JE, Epstein MM, Lowery J, Lu CY, Pawloski PA, Sharaf RN, Liang SY, Burnett-Hartman AN, Gudgeon JM, Hao J, Snyder S, Gogoi R, Ladd I, Williams MS. BMC Health Serv Res. 18(1):824. doi: 10.1186/s12913-018-3636-2. 2018 Oct 30 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/risk-of-gastric-adenocarcinoma-undergoing-routine-care-1055312622#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Risk of Gastric Adenocarcinoma Undergoing Routine Care"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/risk-of-gastric-adenocarcinoma-undergoing-routine-care-1055312622#medicalscholarlyarticle","name":"Risk of Gastric Adenocarcinoma in a Multiethnic Population Undergoing Routine Care: An Electronic Health Records Cohort Study","headline":"Risk of Gastric Adenocarcinoma Undergoing Routine Care","abstract":"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.Methods: This was a retrospective cohort study, with endpoint of GAC incidence as ascertained through linkage to an institutional tumor registry. We utilized 2010–2020 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. Results: 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. Conclusions: Routine EHR data can stratify the general population for GAC risk. 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