Newswise — The American College of Gastroenterology has published its first , which have an increased risk of progression to gastric cancer and include atrophic gastritis, gastric intestinal metaplasia, dysplasia, and certain gastric epithelial polyps. Gastric cancer is 2- to 13-fold greater in non-White individuals, particularly early-generation immigrants from regions of high gastric cancer incidence, with a five-year survival rate of 36% in the United States.
The new guideline includes recommendations, developed using GRADE methodology, on endoscopic surveillance for high-risk patients with GPMC, the performance of high-quality endoscopy and image-enhanced endoscopy for diagnosis and surveillance, GPMC histology criteria and reporting, endoscopic treatment of dysplasia, the role of Helicobacter pylori eradication, general risk reduction measures, and the management of autoimmune gastritis and gastric epithelial polyps.
The recommendations include surveillance endoscopy, typically every three years, for individuals at high risk for GPMC according to endoscopic, histologic, and demographic factors. H. pylori testing, treatment, and eradication confirmation are recommended in all individuals with GPMC, as H. pylori eradication and early gastric cancer resection reduces the risk of gastric cancer.
The authors write that, “These ACG Guidelines for the management of GPMC are a paradigm shift in US clinical practice. Implementation and change in clinical practice will require concrete targets and include training and quality initiatives. It is anticipated that this will begin to address the marked US GC disparity, and the burden on minority and marginalized populations. The overarching goals are to reduce GC incidence in the United States, increase the detection of early stage disease (early GC), and to significantly increase the 5-year survival rates in the near term.”
Citation:
Morgan, Douglas R. MD, MPH, FACG; Corral, Juan E. MD, MPH; Li, Dan MD; Montgomery, Elizabeth A. MD; Riquelme, Arnoldo MD; Kim, John J. MD, FACG; Sauer, Bryan MD, MSc, FACG; Shah, Shailja C. MD, MPH. ACG Clinical Guideline: Diagnosis and Management of Gastric Premalignant Conditions. The American Journal of Gastroenterology ():10.14309/ajg.0000000000003350, March 12, 2025. | DOI: 10.14309/ajg.0000000000003350
About the American College of Gastroenterology
Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of over 19,000 individuals from 86 countries. The College's vision is to be the preeminent organization supporting health care professionals who provide compassionate, equitable, high-quality, state-of-the-art, and personalized care to promote digestive health. The mission of the College is to provide tools, services, and accelerate advances in patient care, education, research, advocacy, practice management, professional development and clinician wellness, enabling our members to improve patients’ digestive health and to build personally fulfilling careers that foster well-being, meaning and purpose. Learn more at .
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