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Endoscopy 2020; 52(04): 293-304
DOI: 10.1055/a-1104-5245
Position Statement

Role of gastrointestinal endoscopy in the screening of digestive tract cancers in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Adrian Săftoiu
 1   Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy, Craiova, Romania
 2   Gastroenterology Department, Regina Maria-Ponderas Academic Hospital, Bucharest, Romania
,
Cesare Hassan
 3   Nuovo Regina Margherita Hospital, Rome, Italy
,
Miguel Areia
 4   Gastroenterology Department, Portuguese Oncology Institute of Coimbra, Portugal
 5   Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto, Portugal
,
Manoop S. Bhutani
 6   Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, The University of Texas, Houston, USA
,
Raf Bisschops
 7   Department of Gastroenterology and Hepatology, Catholic University of Leuven (KUL), TARGID, University Hospitals Leuven, Leuven, Belgium
,
Erwan Bories
 8   Private office, Aix-en-Provence, France
,
Irina M. Cazacu
 1   Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy, Craiova, Romania
 6   Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, The University of Texas, Houston, USA
,
Evelien Dekker
 9   Department of Gastroenterology and Hepatology, Cancer Center Amsterdam, Amsterdam University Medical Centers, The Netherlands
,
Pierre H. Deprez
10   Department of Hepato-Gastroenterology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
,
Stephen P. Pereira
11   Institute for Liver and Digestive Health, Royal Free Hospital Campus, University College London, UK
,
Carlo Senore
12   Epidemiology and Screening Unit-CPO, University Hospital Città della Salute e della Scienza, Turin, Italy
,
Riccardo Capocaccia
13   Editorial Board, Epidemiologia e Prevenzione
,
Giulio Antonelli
 3   Nuovo Regina Margherita Hospital, Rome, Italy
,
Jeanin van Hooft
 9   Department of Gastroenterology and Hepatology, Cancer Center Amsterdam, Amsterdam University Medical Centers, The Netherlands
,
Helmut Messmann
14   III Med Klinik, Klinikum Augsburg, Augsburg, Germany
,
Peter D. Siersema
15   Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
,
Mario Dinis-Ribeiro
 5   Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto, Portugal
16   Gastroenterology Department, Portuguese Oncology Institute of Porto, Portugal
,
Thierry Ponchon
17   Gastroenterology Division, Edouard Herriot Hospital, Lyon, France
› Author Affiliations
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Summary of statements

In Europe at present, but also in 2040, 1 in 3 cancer-related deaths are expected to be caused by digestive cancers. Endoscopic technologies enable diagnosis, with relatively low invasiveness, of precancerous conditions and early cancers, thereby improving patient survival. Overall, endoscopy capacity must be adjusted to facilitate both effective screening programs and rigorous control of the quality assurance and surveillance systems required.

1 For average-risk populations, ESGE recommends the implementation of organized population-based screening programs for colorectal cancer, based on fecal immunochemical testing (FIT), targeting individuals, irrespective of gender, aged between 50 and 75 years. Depending on local factors, namely the adherence of the target population and availability of endoscopy services, primary screening by colonoscopy or sigmoidoscopy may also be recommendable.

2 In high-risk populations, endoscopic screening for gastric cancer should be considered for individuals aged more than 40 years. Its use in countries/regions with intermediate risk may be considered on the basis of local settings and availability of endoscopic resources.

3 For esophageal and pancreatic cancer, endoscopic screening may be considered only in high-risk individuals:

– For squamous cell carcinoma, in those with a personal history of head/neck cancer, achalasia, or previous caustic injury;

– For Barrett’s esophagus (BE)-associated adenocarcinoma, in those with long-standing gastroesophageal reflux disease symptoms (i. e., > 5 years) and multiple risk factors (age ≥ 50 years, white race, male sex, obesity, first-degree relative with BE or esophageal adenocarcinoma [EAC]).

– For pancreatic cancer screening, endoscopic ultrasound may be used in selected high-risk patients such as those with a strong family history and/or genetic susceptibility.



Publication History

Article published online:
12 February 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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