Muhammad Miftahussurur and Langgeng Agung Waskito and Ari Fahrial Syam and Iswan Abbas Nusi and I Dewa Nyoman Wibawa and Yudith Annisa Ayu Rezkitha and Gontar Siregar and OK Yulizal and Fardah Akil and Willy Brodus Uwan and David Simanjuntak and Jimmy BradleyWaleleng and Alexander Michael and Fauzi Yusuf and Hasan Mauleha and Marsellino Richardo and Abdul Rahman and Yoma Sari Namara and Eko Sudarmo and Pangestu Adi and Ummi Maimunah and Husin Thamrin and Poernomo Boedi Setiawan and Kartika Afrida Fauzia and Dallan Doohan and Tomohisa Uchida and Maria Inge Lusida and Yoshio Yamaoka (2019) Analysis of risks of gastric cancer by gastric mucosa among Indonesian ethnic groups. PLOS ONE, 14 (5). pp. 1-19. ISSN 19326203

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Abstract

Indonesia is a big country with multiethnic populations whose gastric cancer risks have not been elucidated. We performed a nationwide survey and obtained histological specimens from 1053 individuals in 19 cities across the country. We examined the gastric mucosa, the topography, the atrophic gastritis risk factors, and the gastric cancer risk scores. Almost half (46.1%) of the patients with dyspeptic symptoms had histological abnormalities; chronic (36.3%) and atrophic gastritis (28.9%) being the most frequent. Individuals of the Timor ethnicity had the highest prevalence of acute (52.6%) and chronic gastritis (68.4%), even those negative for H. pylori. Our topographic analysis showed the majority of patients had predominantly antral acute and chronic gastritis. A multivariate logistic regression model showed age (Odds ratio [OR], 1.107), Timor ethnicity (OR, 8.531), and H. pylori infection (OR, 22.643) as independent risk factors for presence of atrophic gastritis. In addition, the gastric cancer risk score was highest in those from Timor, Papuan, and Bugis ethnic populations. Overall, Indonesia is a low-risk gastric cancer country. However, several ethnic groups displayed severe gastric mucosa symptoms suggesting policy makers should focus on those ethnic groups to perform gastric cancer screenings and to eradicate H. pylori.

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