title: Surveillance of patients with gastric precancerous conditions.
abstract: Intestinal-type gastric adenocarcinoma arises from a multistep process starting with Helicobacter pylori infection followed by gastric atrophy, gastric intestinal metaplasia and dysplasia. Indeed, patients with gastric precancerous conditions or lesions (GPC) are at increased risk to develop gastric cancer even in regions with low incidence. Thus, the identification and surveillance of a high risk subgroup could lead to the diagnosis of cancer at early stage and improve survival. However, both endoscopic and histological accuracy and interobserver agreement in the diagnosis of GPC are still far from optimal. Also, there are conceptual differences between the West and the East in the diagnosis and surveillance of patients. In the former, multiple gastric biopsies are still recommended but Eastern gastroenterologists select patients to surveillance according to the results of endoscopy or serology. In this literature review we describe the cascade of GPC and we highlight the differences between eastern and western clinical practice.
authors.affiliation: Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal. Electronic address: jorgetl86@gmail.com.
authors.forename: Jorge
authors.initials: J
authors.lastname: Lage
authors.affiliation: Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Noriya
authors.initials: N
authors.lastname: Uedo
authors.affiliation: Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal; CINTESIS - Center for Health Technology and Services Research, Porto, Portugal; CIDES-FMUP - Faculty of Medicine of the University of Porto, Porto, Portugal.
authors.forename: Mário
authors.initials: M
authors.lastname: Dinis-Ribeiro
authors.affiliation: Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Kenshi
authors.initials: K
authors.lastname: Yao
mesh_terms: D016099:Endoscopy, Gastrointestinal; D005753:Gastric Mucosa / Q000473:pathology; D005757:Gastritis, Atrophic / Q000175:diagnosis; D006801:Humans; D008679:Metaplasia; D011159:Population Surveillance; D010818:Practice Patterns, Physicians'; D011230:Precancerous Conditions / Q000175:diagnosis*; D013274:Stomach Neoplasms / Q000175:diagnosis*
keywords: Atrophic gastritis; Gastric intestinal metaplasia; Helicobacter pylori; Population surveillance; Stomach neoplasms