Chilean Association of Digestive Endoscopy (ACHED) guidelines for the detection of early gastric cancer and surveillance of gastric premalignant conditions in high-risk populations

Gastric cancer is one of the leading causes of cancer mortality in Chile. To optimize early detection and surveillance of gastric premalignant conditions, the Chilean Association of Digestive Endoscopy (ACHED), together with the Chilean Society of Gastroenterology, updated its 2014 clinical guideline. Using the AGREE II methodology, multidisciplinary working groups conducted systematic reviews in PubMed, Cochrane, and Scielo through December 2024. Recommendations were agreed upon via a Delphi panel (≥80% agreement) and graded according to GRADE, assessing evidence quality and recommendation strength. An expert panel of Chilean and international gastroenterology, endoscopy and pathology specialists reviewed the evidence and reached consensus to issue recommendations for opportunistic gastric cancer screening and surveillance using upper GI endoscopy in adults. These recommendations are feasible to implement in Chile and other Latin American countries with a high incidence of gastric cancer that have the necessary resources available. They complement any future efforts at population screening and aim to improve early detection and prognosis of gastric cancer in high-risk populations.