{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:14:06Z","timestamp":1762474446506,"version":"build-2065373602"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Gastric cancer is a recently recognized challenge in management of familial adenomatous polyposis (FAP), mostly developing in the proximal stomach amid carpeting fundic gland polyposis. Dysplastic lesions in the proximal stomach might be the precursor lesions for gastric cancer in FAP. We aimed to describe incidence of dysplastic lesions in the proximal stomach and to identify risk factors for these dysplastic lesions.<\/jats:p>\n                  <jats:p>Data were collected from FAP patients who had undergone esophagogastroduodenoscopy (EGD) between 2015 and 2023 at our academic center. To identify putative risk factors for dysplastic lesions in the proximal stomach, we used multivariable Cox proportional hazard regression modeling.<\/jats:p>\n                  <jats:p>Among the 196 FAP patients who underwent EGD at our center, 33 (17%) were diagnosed with dysplastic lesions in the proximal stomach. In total 61% were female and median age at diagnosis was 49 years (range 19\u201380). A total of 105 dysplastic lesions were identified. Ten (9.5%) showed high-grade dysplasia. During the study period, seven patients were diagnosed with gastric cancer. Carpeting fundic gland polyposis (\u2265 100 polyps) (hazard ratio [HR] 8.94; P &lt; 0.001), biliary reflux (HR 1.92; P = 0.017), and proton pump inhibitors (HR 1.78; P = 0.014) were significant predictors of dysplastic lesions in the proximal stomach. Advanced Spigelman stage (III\/IV) (HR 0.37; P &lt; 0.001) was associated with a significantly lower risk.<\/jats:p>\n                  <jats:p>Carpeting fundic gland polyposis, biliary reflux, and use of PPIs were identified as putative risk factors for dysplastic lesions in the proximal stomach. Presence of these risk factors should alert endoscopists to assess the stomach more thoroughly.<\/jats:p>","DOI":"10.1055\/a-2731-3533","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:09:16Z","timestamp":1762474156000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Risk factors for dysplastic lesions in the proximal stomach in patients with familial adenomatous polyposis"],"prefix":"10.1055","volume":"13","author":[{"given":"Hicham","family":"Bouchiba","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Department of Gastroenterology and Hepatology, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur S.","family":"Aelvoet","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Department of Gastroenterology and Hepatology, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara A.J.","family":"Bastiaansen","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Department of Gastroenterology and Hepatology, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick M.M.","family":"Bossuyt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Data Science, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4363-0745","authenticated-orcid":false,"given":"Evelien","family":"Dekker","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Department of Gastroenterology and Hepatology, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1126\/science.1651562","article-title":"Identification of FAP locus genes from chromosome 5q21","volume":"253","author":"KW Kinzler","year":"1991","journal-title":"Science"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1016\/0016-5085(78)90716-3","article-title":"Genetics of gastrointestinal polyposis","volume":"74","author":"HJ Bussey","year":"1978","journal-title":"Gastroenterology"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1136\/jmedgenet-2017-104545","article-title":"Extracolonic cancer risk in Dutch patients with APC (adenomatous polyposis coli)-associated polyposis","volume":"55","author":"Z Ghorbanoghli","year":"2018","journal-title":"J Med 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FAP","volume":"16","author":"SJ Walton","year":"2017","journal-title":"Fam Cancer"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1007\/s10689-017-9971-3","article-title":"Gastric cancer in FAP: a concerning rise in incidence","volume":"16","author":"G Mankaney","year":"2017","journal-title":"Fam Cancer"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1016\/j.gie.2018.12.018","article-title":"Endoscopic and histologic features associated with gastric cancer in familial adenomatous polyposis","volume":"89","author":"PJ Leone","year":"2019","journal-title":"Gastrointest Endosc"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1016\/j.cgh.2007.11.018","article-title":"Fundic gland polyp dysplasia is common in familial adenomatous polyposis","volume":"6","author":"LK Bianchi","year":"2008","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1007\/BF02251971","article-title":"Gastroduodenal polyps in patients with familial adenomatous polyposis","volume":"35","author":"JM Church","year":"1992","journal-title":"Dis Colon Rectum"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1097\/PAS.0000000000000146","article-title":"Upper GI tract lesions in familial adenomatous polyposis (FAP): enrichment of pyloric gland adenomas and other gastric and duodenal neoplasms","volume":"38","author":"LD Wood","year":"2014","journal-title":"Am J Surg Pathol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"e257027","DOI":"10.6004\/jnccn.2025.7027","article-title":"Gastric polyposis and cancer in western patients with familial adenomatous polyposis: Epidemiology, detection, and management","volume":"23","author":"AS Aelvoet","year":"2025","journal-title":"J Natl Compr Canc Netw"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1007\/s10689-024-00438-4","article-title":"The challenge of preventing gastric cancer in patients under surveillance for familial adenomatous polyposis","volume":"24","author":"H Bouchiba","year":"2025","journal-title":"Fam Cancer"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1055\/a-1265-2716","article-title":"astric adenomas and their management in familial adenomatous polyposis","volume":"53","author":"I Martin","year":"2021","journal-title":"Endoscopy"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1897-4287-12-4","article-title":"Gastric adenomas in familial adenomatous polyposis are common, but subtle, and have a benign course","volume":"12","author":"S Ngamruengphong","year":"2014","journal-title":"Hered Cancer Clin Pract"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-023-02074-8","article-title":"Risk of gastric adenoma and adenocarcinoma in patients with familial adenomatous polyposis in Japan: a nationwide multicenter study","author":"K Sasaki","year":"2024","journal-title":"J Gastroenterol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1136\/gut.51.4.485","article-title":"Impact of Helicobacter pylori infection and mucosal atrophy on gastric lesions in patients with familial adenomatous polyposis","volume":"51","author":"S Nakamura","year":"2002","journal-title":"Gut"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"4117","DOI":"10.1007\/s10620-023-08097-8","article-title":"Two cases, too little, too late: Surveillance for gastric cancer in patients with FAP","volume":"68","author":"M Varanese","year":"2023","journal-title":"Dig Dis Sci"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"17503","DOI":"10.1038\/s41598-023-44470-3","article-title":"Cluster of lifestyle risk factors for stomach cancer and screening behaviors among Korean 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meta-analysis","volume":"14","author":"A Tran-Duy","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1111\/j.1365-2036.2006.03127.x","article-title":"Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy","volume":"24","author":"M Jalving","year":"2006","journal-title":"Aliment Pharmacol Ther"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"e174546","DOI":"10.1172\/jci.insight.174546","article-title":"Region-specific Wnt signaling responses promote gastric polyp formation in patients with familial adenomatous polyposis","volume":"8","author":"KP McGowan","year":"2023","journal-title":"JCI Insight"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"191","DOI":"10.3164\/jcbn.2008028","article-title":"Gastric epithelial cell modality and proton pump inhibitor","volume":"42","author":"T Masaoka","year":"2008","journal-title":"J Clin Biochem 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Brosens","year":"2016","journal-title":"Int J Surg Pathol"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.gie.2016.03.1499","article-title":"Macroscopically visible flat dysplasia in the fundus of 3 patients with familial adenomatous polyposis","volume":"85","author":"L Calavas","year":"2017","journal-title":"Gastrointest Endosc"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1016\/j.gie.2021.06.010","article-title":"Gastric neoplasms in patients with familial adenomatous polyposis: endoscopic and clinicopathologic features","volume":"94","author":"Y Shimamoto","year":"2021","journal-title":"Gastrointest Endosc"}],"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2731-3533.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:09:18Z","timestamp":1762474158000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2731-3533"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,6]]},"references-count":35,"journal-issue":{"issue":"CP","published-online":{"date-parts":[[2025,1,7]]},"published-print":{"date-parts":[[2025]]}},"alternative-id":["a27313533"],"URL":"https:\/\/doi.org\/10.1055\/a-2731-3533","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,6]]}}}