Evidence insufficient for making recommendation on upper endoscopic screening or gastric cancer/GPMC detection in high-risk patients
By Elana Gotkine HealthDay Reporter
TUESDAY, March 25, 2025 (HealthDay News) — In a clinical guideline issued by the American College of Gastroenterology and published online March 12 in the American Journal of Gastroenterology, recommendations are presented for the diagnosis and management of gastric premalignant conditions (GPMC).
Douglas R. Morgan, M.D., M.P.H., from the University of Alabama at Birmingham, and colleagues developed recommendations for the diagnosis and management of GPMC, including surveillance for high-risk patients, performance of endoscopy for diagnosis and surveillance, and endoscopic treatment of dysplasia.
The authors note that the evidence is insufficient for making a recommendation on upper endoscopic screening for gastric cancer (GC)/GPMC detection in U.S. populations deemed high risk for GC. For individuals at high risk for GPMC progression, as defined by endoscopic, histologic, and demographic factors, surveillance endoscopy is recommended, typically every three years, but an individualized interval may be warranted. For all individuals with GPMC, Helicobacter pylori testing, treatment, and eradication confirmation are recommended. A lack of extensive high-quality data is noted for U.S. populations regarding GPMC management, but data are continuing to accrue and the quality of evidence presented should be interpreted accordingly.
“Implementation and change in clinical practice will require concrete targets and include training and quality initiatives. It is anticipated that this will begin to address the marked U.S. GC disparity, and the burden on minority and marginalized populations,” the authors write. “The overarching goals are to reduce GC incidence in the United States, increase the detection of early-stage disease (early GC), and to significantly increase the five-year survival rates in the near term.”
Several authors disclosed ties to the biopharmaceutical industry.
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