Huang RJ, Ende AR, Singla A, et al. - Since gastric intestinal metaplasia (GIM) is an important precursor to gastric cancer (GC), the world's second leading cause of cancer deaths, researchers examined data on the prevalence, risk factors and patterns of clinical practice in the US for GIM. Also, there are currently no US screening/surveillance guidelines for GIM. Between 1999 and 2014, all consecutive upper endoscopic procedures from two academic medical centers in Seattle were reviewed. At the time of endoscopy, they recorded demographic, clinical, and endoscopic covariates. Utilizing univariate and multivariable regression, cases of GIM and dysplasia are recorded and compared with non-GIM controls. Data were obtained from 36,799 upper endoscopies, 17,710 gastric biopsies, 2,073 GIM cases, 43 dysplasia cases, and 78 GC cases. In patients who underwent gastric biopsy, the point prevalence of GIM was 11.7%. GIM was associated with non-white race, increasing age, and presence of Helicobacter pylori. If GIM was present, increasing age and male gender were correlated with progression, and the presence of H pylori was inversely related to dysplasia/GC progression. There were a few cases of GIM/dysplasia/GC during GIM screening/surveillance procedures. Only 16% of GIM diagnosed patients received a surveillance recommendation. Non-white and Hispanic Americans had a high incidence of GIM. Risk factors for GIM development can differ from the risk factors for GC progression.