Surveillance of Gastric Intestinal Metaplasia: Is It Warranted?

Abstract

Despite a decline in incidence over time, gastric adenocarcinoma remains one of the most common and lethal malignancies worthwhile. Nonetheless, endoscopic surveillance of gastric intestinal metaplasia (IM), a precursor lesion, remains controversial with lack of uniform guidelines. Trials have shown a roughly 6-fold increased risk of gastric cancer in the context of IM, with evidence of earlier stage detection and improved 5-year survival with routine surveillance protocols. Thorough pursuit and treatment of Helicobacter pylori infection seems warranted, as IM severity scores appear to improve post eradication. Conventional and digital chromoendoscopy may be the way of the future, while appro