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[Recommendations of the Chilean Association for Digestive Endoscopy for the management of gastric pre-malignant lesions]. | LitMetric

AI Article Synopsis

  • An expert panel provided 24 recommendations aimed at preventing gastric cancer (CG) in symptomatic patients by emphasizing the importance of upper GI endoscopy.
  • Key recommendations include eradicating H. pylori infection, conducting systematic gastric biopsies for specific demographics, and using the OLGA system to assess individual risk of CG.
  • The guidelines also highlight the need for structured endoscopic follow-up based on risk levels and advocate for necessary resources and quality indicators in healthcare institutions.

Article Abstract

An expert panel analyzed the available evidence and reached a consensus to release 24 recommendations for primary and secondary prevention of gastric cancer (CG) in symptomatic patients, with indication for upper GI endoscopy. The main recommendations include (1) Search for and eradicate H. pylori infection in all cases. (2) Systematic gastric biopsies (Sydney protocol) in all patients over 40 years of age or first grade relatives of patient with CG, to detect gastric atrophy, intestinal metaplasia or dysplasia. (3) Incorporate the OLGA system (Operative Link on Gastritis Assessment) to the pathological report, to categorize the individual risk of CG. (4) Schedule endoscopic follow-up according to the estimated risk of CG, namely annual for OLGA III- IV, every 3 years for OLGA I- II or persistent H. pylori infection, every 5 years for CG relatives without other risk factors and no follow-up for OLGA 0, H. pylori (-). (4) Establish basic human and material resources for endoscopic follow-up programs, including some essential administrative processes, and (5) Suggest the early CG/total CG diagnosis ratio of each institution and the proportion of systematic recording of endoscopic images, as quality indicators. These measures are applicable using currently available resources, they can complement any future screening programs for asymptomatic population and may contribute to improve the prognosis of CG in high-risk populations.

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Source
http://dx.doi.org/10.4067/S0034-98872014000900013DOI Listing

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