TY - JOUR
T1 - Chilean consensus by expert panel using the Delphi technique for primary and secondary prevention of gastric cancer
AU - Corsi Sotelo, Óscar
AU - Pizarro Rojas, Margarita
AU - Rollán Rodríguez, Antonio
AU - Silva Figueroa, Verónica
AU - Araya Jofré, Raúl
AU - Bufadel Godoy, María Ester
AU - Cortés González, Pablo
AU - González Donoso, Robinson
AU - Fuentes López, Eduardo
AU - Latorre Selvat, Gonzalo
AU - Medel-Jara, Patricio
AU - Reyes Placencia, Diego
AU - Pizarro Véliz, Mauricio
AU - Garchitorena Marqués, María Jesús
AU - Zegers Vial, María Trinidad
AU - Crispi Galleguillos, Francisca
AU - Espinoza, Manuel A.
AU - Riquelme Pérez, Arnoldo
N1 - Publisher Copyright:
© 2024 Elsevier España, S.L.U.
PY - 2024/10
Y1 - 2024/10
N2 - Introduction: Gastric cancer (GC) is the first cause of cancer-related death in Chile and 6th in Latin America and the Caribbean (LAC). Helicobacter pylori (H. pylori) is the main gastric carcinogen, and its treatment reduces GC incidence and mortality. Esophageal-gastro-duodenoscopy (EGD) allows for the detection of premalignant conditions and early-stage GC. Mass screening programs for H. pylori infection and screening for premalignant conditions and early-stage GC are not currently implemented in LAC. The aim of this study is to establish recommendations for primary and secondary prevention of GC in asymptomatic standard-risk populations in Chile. Methods: Two on-line synchronous workshops and a seminar were conducted with Chilean experts. A Delphi panel consensus was conducted over 2 rounds to achieve >80% agreement on proposed primary and secondary prevention strategies for the population stratified by age groups. Results: 10, 12, and 12 experts participated in two workshops and a seminar, respectively. In the Delphi panel, 25 out of 37 experts (77.14%) and 28 out of 52 experts (53.85%) responded. For the population aged 16-34, there was no consensus on non-invasive testing and treatment for H. pylori, and the use of EGD was excluded. For the 35-44 age group, non-invasive testing and treatment for H. pylori is recommended, followed by subsequent test-of-cure using non-invasive tests (stool antigen test or urea breath test). In the ≥45 age group, a combined strategy is recommended, involving H. pylori testing and treatment plus non-invasive biomarkers (H. pylori IgG serology and serum pepsinogens I and II); subsequently, a selected group of subjects will undergo EGD with gastric biopsies (Sydney Protocol), which will be used to stratify surveillance according to the classification Operative Link for Gastritis Assessment (OLGA); every 3 years for OLGA III-IV and every 5 years for OLGA I-II. Conclusion: A “test-and-treat” strategy for H. pylori infection based on non-invasive studies (primary prevention) is proposed in the 35-44 age group, and a combined strategy (serology and EGD) is recommended for the ≥45 age group (primary and secondary prevention). These strategies are potentially applicable to other countries in LAC.
AB - Introduction: Gastric cancer (GC) is the first cause of cancer-related death in Chile and 6th in Latin America and the Caribbean (LAC). Helicobacter pylori (H. pylori) is the main gastric carcinogen, and its treatment reduces GC incidence and mortality. Esophageal-gastro-duodenoscopy (EGD) allows for the detection of premalignant conditions and early-stage GC. Mass screening programs for H. pylori infection and screening for premalignant conditions and early-stage GC are not currently implemented in LAC. The aim of this study is to establish recommendations for primary and secondary prevention of GC in asymptomatic standard-risk populations in Chile. Methods: Two on-line synchronous workshops and a seminar were conducted with Chilean experts. A Delphi panel consensus was conducted over 2 rounds to achieve >80% agreement on proposed primary and secondary prevention strategies for the population stratified by age groups. Results: 10, 12, and 12 experts participated in two workshops and a seminar, respectively. In the Delphi panel, 25 out of 37 experts (77.14%) and 28 out of 52 experts (53.85%) responded. For the population aged 16-34, there was no consensus on non-invasive testing and treatment for H. pylori, and the use of EGD was excluded. For the 35-44 age group, non-invasive testing and treatment for H. pylori is recommended, followed by subsequent test-of-cure using non-invasive tests (stool antigen test or urea breath test). In the ≥45 age group, a combined strategy is recommended, involving H. pylori testing and treatment plus non-invasive biomarkers (H. pylori IgG serology and serum pepsinogens I and II); subsequently, a selected group of subjects will undergo EGD with gastric biopsies (Sydney Protocol), which will be used to stratify surveillance according to the classification Operative Link for Gastritis Assessment (OLGA); every 3 years for OLGA III-IV and every 5 years for OLGA I-II. Conclusion: A “test-and-treat” strategy for H. pylori infection based on non-invasive studies (primary prevention) is proposed in the 35-44 age group, and a combined strategy (serology and EGD) is recommended for the ≥45 age group (primary and secondary prevention). These strategies are potentially applicable to other countries in LAC.
KW - Chile
KW - Early detection of cancer
KW - Endoscopy
KW - Gastrointestinal
KW - Helicobacter pylori
KW - Primary prevention
KW - Stomach neoplasms
UR - https://www.scopus.com/pages/publications/85187367914
U2 - 10.1016/j.gastrohep.2024.01.008
DO - 10.1016/j.gastrohep.2024.01.008
M3 - Article
C2 - 38311004
AN - SCOPUS:85187367914
SN - 0210-5705
VL - 47
SP - 845
EP - 857
JO - Gastroenterologia y Hepatologia
JF - Gastroenterologia y Hepatologia
IS - 8
ER -
