Gastroenterologists' attitudes on the detection and management of gastric premalignant conditions: results of a nationwide survey in Spain. Issue 6 (23rd December 2020)

• Record Type: Journal Article
• Authors: Delgado-Guillena, Pedro Genaro; Morales-Alvarado, Victor Jair; Elosua-González, Alfonso; Murcia Pomares, Oscar; Pérez-Aisa, Angeles; Córdova, Henry; Alcedo, Javier; Calvet, Xavier; Fernández-Esparrach, Gloria
• Is Part Of: European journal of cancer prevention. Volume 30:Issue 6(2021)
• Page Start: 431
• Page End: 436
• Publication Date: 2020-12-23
• Subjects: esophagogastroduodenoscopy -- gastric cancer -- premalignant lesions -- quality indicators; Cancer -- Prevention -- Periodicals; Neoplasms -- etiology -- Periodicals; Neoplasms -- prevention & control -- Periodicals; Cancer -- Prevention; Periodicals; 616.994052
• DOI: 10.1097/CEJ.0000000000000648
• Languages: English
• ISSNs: 0959-8278

Abstract

Abstract : Supplemental Digital Content is available in the text. Abstract : Introduction: Gastric premalignant conditions (GPC) surveillance has been proposed to improve the prognosis of gastric cancer (GC), but the early GC detection rate remaining low, and missing GC during an esophago-gastro-duodenoscopy is still a problem. We aimed to explore the gastroenterologists' attitudes on the detection and management of GPC Methods: A cross-sectional study was designed based on a survey among gastroenterologists from Asociación Española de Gastroenterología. Results: The participation rate was 12% (146/1243). Eighty-one percent worked at secondary or tertiary-care hospitals with the capability to perform mucosectomy (80%), but with a lesser availability of endoscopic submucosal dissection (35%). Most respondents had high-definition endoscopes (88%), and virtual chromoendoscopy (86%), but during performing an upper endoscopy, 34% never or rarely use chromoendoscopy, and 73% apply a biopsy protocol often/very often when atrophy or intestinal metaplasia (IM) is suspected. Half of the respondents self-reported their ability to recognize atrophy or IM ≤7 (on a scale from 0 to 10), whereas ≤6 for dysplasia or early GC. Helicobacter pylori infection is eradicated and verified by ≥90%. Endoscopic surveillance of atrophy/IM is performed by 62%. An immediate endoscopy for dysplasia is not always performed. For low-grade dysplasia, 97.6% consider endoscopic management, but for high-grade dysplasia, 23% regard gastric surgery. Conclusion: There is a wide variability in the detection and management of GPC among Spanish gastroenterologists, and compliance with guidelines and biopsy protocols could be improved. Performance of high-quality gastroscopies including use of virtual chromoendoscopy, that might allow an improvement in the GPC detection, needs also to be generalized.