Recent US Gastric Cancer Prevention Recommendations: Advances, Unanswered Questions, and the Need for a Unified Approach.

Abstract

In the past year, two major American gastroenterology societies have introduced pivotal updates to their recommendations for gastric cancer (GC) prevention.^– The American College of Gastroenterology (ACG) released new guidelines on <i>Helicobacter pylori</i> management, recommending screen-and-treat to individuals at high-risk for GC, as well as guidelines on the management of gastric precursor lesions. Moreover, the American Gastroenterological Association (AGA) issued a clinical practice update (CPU) focusing on endoscopic screening and surveillance of high-risk groups for GC. These updates represent important advances in the rapidly evolving landscape of GC prevention. However, key differences in focus — between <i>H pylori</i> screen-and-treat vs endoscopic screening — may leave health care providers uncertain which to prioritize and which populations to consider for these interventions. In this commentary, we aim to provide a perspective on GC prevention integrating these recommendations, highlighting the unanswered questions they raise, and proposing new research avenues.