title: Surveillance strategy of atrophic gastritis and intestinal metaplasia in a country with a high prevalence of gastric cancer.
abstract: BACKGROUND
  It is not clear which screening examinations are best suited for gastric cancer prevention, especially in patients with atrophic gastritis and intestinal metaplasia. Therefore, we investigated the gastric cancer screening methods and intervals that are performed in clinical practice in an area with a high prevalence of gastric cancer.
  
  
  METHODS
  Eighty-seven physicians voted by keypad and discussed the consistency of endoscopic diagnosis of atrophic gastritis and intestinal metaplasia at the Annual Symposium of the Korean College of Helicobacter and Upper Gastrointestinal Research. Additionally, 100 core members of this academic society were asked via e-mail to complete the questionnaires related to screening strategies for gastric cancer.
  
  
  RESULTS
  The most common recommendation for the subjects with intestinal metaplasia was an annual endoscopic follow-up (95.5% vs. 80.4% in the expert and non-expert groups, respectively; P = 0.118). Annual endoscopic follow-up was also the most predominant recommendation for atrophic gastritis (95.5% vs. 76.5%; P = 0.092), regardless of the physicians' endoscopic experience, position, and degree of the hospital. However, the correct answer rate for the diagnosis of normal endoscopic findings was only 16.7 and 14.1% in the expert and non-expert groups, respectively (P = 0.883).
  
  
  CONCLUSIONS
  The most common practical screening strategy for patients with atrophic gastritis and intestinal metaplasia in Korea was annual endoscopic examination. However, a new program estimating individualized gastric cancer risk might be needed because of the low inter-observer agreement in the endoscopic diagnosis of atrophic gastritis and intestinal metaplasia.
authors: Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
authors: Woon Geon
authors: WG
authors: Shin
authors: Heung Up
authors: HU
authors: Kim
authors: Ho June
authors: HJ
authors: Song
authors: Su Jin
authors: SJ
authors: Hong
authors: Ki-Nam
authors: KN
authors: Shim
authors: In-Kyung
authors: IK
authors: Sung
authors: Jae Gyu
authors: JG
authors: Kim
mesh_terms: D000368:Aged; D016099:Endoscopy, Gastrointestinal / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005757:Gastritis, Atrophic / Q000145:classification / Q000208:ethnology* / Q000473:pathology; D019538:Health Care Surveys / Q000379:methods; D006801:Humans; D007410:Intestinal Diseases / Q000208:ethnology* / Q000473:pathology; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D008511:Medicine / Q000706:statistics & numerical data; D008679:Metaplasia; D008875:Middle Aged; D015588:Observer Variation; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000208:ethnology* / Q000473:pathology / Q000517:prevention & control*