Huang RJ, Ende AR, Singla A, et al. - Given that gastric intestinal metaplasia (GIM) is an important precursor to gastric cancer (GC), the world's second leading cause of cancer deaths, researchers analyzed data on the prevalence, risk factors and patterns of clinical practice in the United States for GIM. In addition, there are currently no US screening/surveillance guidelines for GIM. Between 1999 and 2014, all consecutive upper endoscopic procedures from 2 academic medical centers in Seattle are reviewed. At the time of endoscopy, demographic, clinical, and endoscopic covariates are recorded. Using univariate and multivariable regression, cases of GIM and dysplasia are recorded and compared with non-GIM controls. Data were captured 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 is 11.7%. Non-white race, increasing age, and presence of Helicobacter pylori linked to GIM. Once GIM is present, progression is associated with increasing age and male gender, and the presence of H pylori is inversely associated with dysplasia/GC progression. There are a few cases of GIM/dysplasia/GC during GIM screening/surveillance procedures. Only 16% of GIM diagnosed patients received a surveillance recommendation. Findings suggested that risk factors for GIM development may differ from risk factors for GC progression.