Variations in society recommendations for the management of gastric intestinal metaplasia
| Geographic location | Society recommendations |
|---|---|
| East Asia | Endoscopic or radiographic screening of all men and women at age 50 or older29 In patients with gastric intestinal metaplasia and high-risk features, endoscopy recommended in 1 to 3 years |
| Europe | Patients with extensive gastric intestinal metaplasia should undergo endoscopic surveillance every 3 years Consider endoscopic surveillance in patients with gastric intestinal metaplasia limited to the corpus or antrum of the stomach but with a family history of gastric cancer, persistent Helicobacter pylori infection, incomplete gastric intestinal metaplasia, or autoimmune gastritis30 |
| United States | AGA recommends against routine endoscopic surveillance after gastric intestinal metaplasia is detected in the general population, but if H pylori is detected, treatment is encouraged Patients with gastric intestinal metaplasia and risk factors associated with progression could be considered for endoscopic surveillance every 3 to 5 years if the patient favors surveillance (which has an unclear impact on mortality risk) vs endoscopic evaluation, which has a risk of complications31 ASGE recommends endoscopic surveillance exclusively in patients with risk factors, but not in the general cohort of patients in whom gastric intestinal metaplasia is detected32 |
AGA = American Gastroenterological Association; ASGE = American Society for Gastrointestinal Endoscopy