2017-10-11 18:49:46 UTC

Does Surveillance of Gastric Intestinal Metaplasia Make Sense?

Oct. 11, 2017

Two members provide two different perspectives. Let us know what you think.

Gastric intestinal metaplasia (GIM) is commonly found during routine endoscopy. GIM can be an early step in gastric carcinogenesis, but does that mean that all patients with GIM should qualify for continued surveillance?

Ernst J. Kuipers, MD, PhD, AGAF, makes the case in AGA Perspectives that consistent surveillance makes sense and should be in line with esophageal and colorectal surveillance. Dr. Kuipers details how constancy in the clinical approach to patients is critical as roughly one-fifth of all human cancers arise in the gastrointestinal tract, affecting 3.5 million new patients worldwide every year. 

M. Brian Fennerty, MD, AGAF, suggests that overdoing surveillance can be harmful for patients, leading to unnecessary procedures that potentially reduce the quality of life of the patient. In his AGA Perspective article, Dr. Fennerty states that it only makes sense to conduct surveillance in patients with GIM associated dysplasia, with GIM and first-degree relatives with gastric cancer, or with first-generation immigrants from a high gastric cancer incident region that has extensive GIM.

Where do you stand on the debate? Let us know in the AGA Community.

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