Ebigbo Alanna, Messmann Helmut, Römmele Christoph
Department of Gastroenterology, III. Medizinische Klinik, Universitätsklinikum Augsburg, Augsburg, Germany.
Visc Med. 2019 Aug;35(4):240-244. doi: 10.1159/000501889. Epub 2019 Jul 25.
The rationale behind endoscopic screening of the upper gastrointestinal tract (GIT) in the West is different from Asian countries with a high prevalence of gastric cancer. If epidemiological data on upper GIT cancer in the Western world is considered, then endoscopic screening of the upper GIT must target premalignant conditions as well and, furthermore, lay emphasis on the assessment of the entire upper GIT in high-risk individuals from the mouth till the duodenum. Although data on the incidence, prevalence, and further development of premalignant conditions in the upper GIT is lacking, a risk-based approach to endoscopic screening will be more cost-effective than a general screening approach. Finally, endoscopists need to be educated and trained in the assessment of the upper GIT during screening endoscopy.
在西方,对上消化道(GIT)进行内镜筛查的基本原理与胃癌高发的亚洲国家不同。如果考虑西方世界上消化道癌症的流行病学数据,那么上消化道的内镜筛查必须也针对癌前病变,此外,要着重对高危个体从口腔到十二指肠的整个上消化道进行评估。尽管缺乏关于上消化道癌前病变的发病率、患病率及进一步发展的数据,但基于风险的内镜筛查方法将比一般筛查方法更具成本效益。最后,内镜医师需要接受关于筛查性内镜检查中上消化道评估的教育和培训。