Diagnóstico precoz de cáncer gástrico. Propuesta de detección y seguimiento de lesiones premalignas gástricas: protocolo ACHED
Date
2014
Type:
Artículo
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12
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ORCID:
Journal Title
Journal ISSN
Volume Title
Publisher
Sociedad Médica de Santiago
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Abstract
An expert panel analyzed the available evidence and reached a consensus
to release 24 recommendations for primary and secondary prevention
of gastric cancer (CG) in symptomatic patients, with indication for upper
GI endoscopy. The main recommendations include (1) Search for and
eradicate H. pylori infection in all cases. (2) Systematic gastric biopsies
(Sydney protocol) in all patients over 40 years of age or first grade relatives
of patient with CG, to detect gastric atrophy, intestinal metaplasia or
dysplasia. (3) Incorporate the OLGA system (Operative Link on Gastritis
Assessment) to the pathological report, to categorize the individual risk
of CG. (4) Schedule endoscopic follow-up according to the estimated risk
of CG, namely annual for OLGA III- IV, every 3 years for OLGA I- II or
persistent H. pylori infection, every 5 years for CG relatives without other
risk factors and no follow-up for OLGA 0, H. pylori (-). (4) Establish
basic human and material resources for endoscopic follow-up programs,
including some essential administrative processes, and (5 ) Suggest the
early CG/total CG diagnosis ratio of each institution and the proportion
of systematic recording of endoscopic images, as quality indicators. These
measures are applicable using currently available resources, they can complement
any future screening programs for asymptomatic population and
may contribute to improve the prognosis of CG in high-risk populations
Description
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Citation
Revista Médica de Chile,July 2014, vol.142,p.1181-1192
Keywords
Gastric neoplasms, Health planning guidelines, Mass screening