Surveillance of gastric intestinal metaplasia for the prevention of gastric cancer.
BACKGROUND
Adenocarcinoma of the stomach is the second leading cause of cancer related death in the world. Gastric intestinal metaplasia (GIM) is a recognised premalignant condition of the stomach. It has been described as occurring in up to one in five patients in western countries. Although there is a definite risk of progression from GIM to cancer, published guidelines and statements differ as to the utility and structure of surveillance programs for this condition.


OBJECTIVE
To see whether or not endoscopic or biochemical surveillance of patients with gastric intestinal metaplasia (GIM) could result in increased detection of dysplasia and early gastric cancer to decrease gastric cancer mortality.


METHODS
We performed a search of the following electronic databases from inception to October 2012: CENTRAL, EMBASE, MEDLINE and LILACS. We handsearched for abstracts from relevant conferences.


METHODS
Randomised controlled trials only were included.


METHODS
No studies met the inclusion criteria.


RESULTS
No studies met the inclusion criteria.


CONCLUSIONS
There is a lack of randomised data on the utility of surveillance of GIM. The observational data from non-randomised studies are discussed and would suggest that although a randomised trial would be a desirable undertaking to attain the highest grade of clinical evidence, given the ethical and acceptability issues involved, further non-randomised clinical studies focussing on surveillance protocols and the role of Helicobacter pylori eradication may be a more pragmatic means of addressing the core clinical question.
Department of Gastroenterology and Clinical Medicine, Adelaide and Meath Hospital incorporating the National Children's Hospital/Trinity College, Belgard Road, Tallaght, Dublin, Ireland, D24.
Anthony
A
O'Connor
Deirdre
D
McNamara
Colm A
CA
O'Moráin
D000230:Adenocarcinoma / Q000517:prevention & control*; D006801:Humans; D008679:Metaplasia / Q000175:diagnosis; D011230:Precancerous Conditions / Q000175:diagnosis*; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000517:prevention & control*