Comprehensive Analysis of Racial and Gender Disparities in GIM Improvement with PPI Treatment: Insights from In-House Data (2009–2023)

Aims Proton pump inhibitors (PPIs) are widely used to treat gastrointestinal disorders, including gastric intestinal metaplasia (GIM), a precancerous condition marked by abnormal stomach lining changes, raising gastric cancer risk. This study evaluates PPI effectiveness in improving GIM across racial groups, focusing on disparities among Asians, Black/African Americans, Hispanics, and Whites. By analyzing post-treatment GIM status, we aim to understand how racial and gender differences impact PPI therapy efficacy and inform tailored treatment for diverse populations

Methods The study examined 4300 patients with Gastric Intestinal Metaplasia from 2009-2023, with 377 undergoing repeat endoscopies after≥8 weeks of PPI therapy. Chi-square tests evaluated PPI's impact on GIM status, considering post-treatment status, race, and gender. The primary analysis compared GIM improvement post-8-week PPI treatment. Secondary analyses assessed improvement across races (Asian, Black/African American, Hispanic, White) and genders. P-values determined statistical significance.

Results The study population included males and females from diverse racial backgrounds. Asian, Black/African American, Hispanic, and White. Among the participants, the gender distribution was 40% female and 60% male. Racially, the population comprised 10% Asian, 50% Black/African American, 15% Hispanic, and 25% White. Results indicate significant improvement with PPI (Chi2=13.12, p=0.0003). Significant racial disparities were observed (Chi2=165.48, p=0.0000), with Black/African Americans exhibiting the most improvement. Moreover, a gender difference was noted (Chi2=22.03, p=0.0000026), favoring females

Conclusions The study reveals significant PPI-induced GIM improvement, with notable racial and gender disparities. Black/African Americans exhibit the most substantial enhancement, possibly due to genetic or environmental factors. Females also show greater improvement, suggesting hormonal or behavioral influences. These findings emphasize personalized GIM management, considering racial and gender variations for optimal outcomes. Further research is essential to unravel underlying mechanisms and develop targeted interventions ensuring equitable healthcare benefits. This study lays a critical groundwork for reducing gastric cancer risks via effective GIM management with PPI therapy.

Publication History

Article published online:
27 March 2025