Asociación Española
de Gastroenterología
Esófago-Estómago-Duodeno

Pilar García Iglesias
Coordinador

El grupo de trabajo de Esófago-Estómago-Duodeno (EED) fue constituido en 1999 y desde entonces agrupa a los socios de AEG interesados en la fisiología y las enfermedades de los órganos mencionados, y recoge algunas otras patologías gastroenterológicas que pueden afectar a tramos más distales del tubo digestivo.


Gastroenterologists’ attitudes on the detection and management of gastric premalignant conditions: results of a nationwide survey in Spain
2020 Pedro Delgado Endoscopy Unit, Hospital General of Granollers, University of Barcelona, Barcelona 58
Revista
European Journal of Cancer Prevention

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 esophagogastro-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 lowgrade 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. 


DOI: 10.1097/CEJ.0000000000000648