Identifying high-risk individuals for gastric cancer surveillance from western and eastern perspectives: Lessons to learn and possibility to develop an integrated approach for daily practice

摘要: Current evidence shows that individuals with gastric dysplasia, severe and extensive atrophy, intestinal metaplasia the incomplete subtype of are at high risk for cancer (GC) development. There several approaches to identifying these subjects, including noninvasive methods, esophagogastroduodenoscopy histology. The main approach in Western countries is histology-based while Eastern a prevalence GC endoscopy-based. Regarding asymptomatic individuals, key issues selecting applicable ability reduce mortality cost-effectiveness approach. At present, population-based screening programs have only been applied few Asian GC. Pre-endoscopic assessment based on demographic clinical features, such as ethnicity, age, gender, smoking Helicobacter pylori status, helpful subjects pre-test probability possibly cost-effective approach, especially intermediate- low-risk countries. symptomatic patients indications esophagogastroduodenoscopy, importance opportunistic should be emphasized. combination endoscopic histological always considered endoscopy provides real-time patient's level. In addition, imaging enhanced (IEE) has shown facilitate targeted biopsies resulting better correlation between findings. Currently, use IEE recommended examinations, Operative Link Gastric Intestinal Metaplasia or Gastritis Assessment grading systems examinations whenever available. However, resource limitations an important barrier many regions worldwide. Thus, real-life practice, it not evidence-based but also resource-sensitive. this review, we discuss current understanding high-risk from western eastern perspectives, well possibility integrated, resource-sensitive