Gastric Polyps: Examining Adherence to Polypectomy Guidelines and the Role of Demographic and Clinical Data in Endoscopic Management

Introduction: Gastric polyps are found on 6% of EGDs and encompass a wide range of epithelial and sub-epithelial lesions. Although commonly visualized as an incidental finding, malignant potential cannot be determined from endoscopic appearance alone; thus, excision and biopsy are recommended by the American Society for Gastrointestinal Endoscopy (ASGE). This study sought to assess adherence to the American Society for Gastrointestinal Endoscopy (ASGE) guidelines regarding resection of gastric polyps and to identify clinical and demographic data influencing endoscopic management. The primary aim is to determine if 50% of all gastric polyps visualized during non-emergent esophagogastroduodenoscopies (EGDs) are excised as recommended. The secondary aim is to identify leading demographic, clinical, and pharmacologic data influencing endoscopic management. Methods: In this retrospective study, 600 medical records were queried for patients ages 18 to 90 undergoing non-urgent EGD from October 17th, 2020, to October 17th, 2021, at Westchester Medical Center (WMC). Demographic, clinical, and histopathologic data were extracted. Descriptive statistics and analytics were completed via SPSS to assess associations to polypectomies. Results: Preliminary results from 300 medical records indicated >80% of gastric polyps visualized were excised according to ASGE guidelines, with >70% of histopathologies indicative of fundic gland polyps. Gastric polyps were less likely to be excised when EGD was performed in the setting of gastrointestinal bleeds or esophageal varices screening in patients with cirrhosis. Histopathology was more likely to indicate malignancy in patients with a history of tobacco use and those with a family history of gastrointestinal malignancy. Conclusion: This study confirmed polypectomies were performed in >80% of routine EGDs as recommended by ASGE guidelines, with strong associations seen between PPI use and fundic gland polyps as well as malignancies in patients with strong family histories.