Endoscopy 2020; 52(06): 491-497
DOI: 10.1055/a-1137-4721
Position statement

Digestive findings that do not require endoscopic surveillance – Reducing the burden of care: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Enrique Rodríguez-de-Santiago   *
1   Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y Cajal, University of Alcala, IRYCIS, Madrid, Spain
,
Leonardo Frazzoni   *
2   Department of Medical and Surgical Sciences DIMEC, University of Bologna, Italy
,
Lorenzo Fuccio
2   Department of Medical and Surgical Sciences DIMEC, University of Bologna, Italy
,
Jeanin E van Hooft
3   Department of Gastroenterology and Hepatology, Cancer Center Amsterdam, Amsterdam University Medical Centers, The Netherlands
,
Thierry Ponchon
4   Gastroenterology Division, Edouard Herriot Hospital, Lyon, France
,
Cesare Hassan
5   Nuovo Regina Margherita Hospital, Rome, Italy
,
Mário Dinis-Ribeiro
6   Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto, Portugal
7   Gastroenterology Department, Portuguese Oncology Institute of Porto, Portugal
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Summary of Statements

With the aim of reducing the overall burden of care, ESGE recommends against surveillance of a series of conditions. Namely:

ESGE recommends against surveillance of individuals with the following: an inlet esophageal patch; Los Angeles (LA) grade A or B erosive esophagitis; or < 1 cm columnar-lined esophagus.

ESGE recommends against surveillance of those with intestinal metaplasia limited to the antrum unless additional risk factors are present, such as persistent Helicobacter pylori infection, incomplete metaplasia, or a family history of gastric cancer; or for fundic gland polyps in the absence of suspicious endoscopic features or hereditary syndromes.

ESGE recommends against surveillance of gastrointestinal leiomyomas, lipomas, and antral pancreatic rests, provided that these lesions have typical ultrasonographic features.

ESGE recommends against routine endoscopic surveillance in duodenal peptic ulcer, unless symptoms persist despite adequate therapy.

ESGE suggests against surveillance of confirmed pancreatic serous cystic neoplasms.

ESGE recommends against endoscopic surveillance for patients with hyperplastic polyps in the rectosigmoid, with 1 – 4 adenomas < 10 mm with low-grade dysplasia, or with a serrated polyp < 10 mm without dysplasia.

ESGE recommends against surveillance of gastrointestinal conditions in individuals over 80 years old who have less than 10 years of life expectancy and poor general health status.

* These authors contributed equally.




Publication History

Article published online:
14 April 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Peery AF, Crockett SD, Murphy CC. et al. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: Update 2018. Gastroenterology 2019; 156: 254-272.e11
    CrossrefPubMedGoogle Scholar
  • 2 O’Morain N, O’Morain C. The burden of digestive disease across Europe: Facts and policies. Dig Liver Dis 2019; 51: 1-3
    CrossrefPubMedGoogle Scholar
  • 3 Yang JD, Mannalithara A, Piscitello AJ. et al. Impact of surveillance for hepatocellular carcinoma on survival in patients with compensated cirrhosis. Hepatology 2018; 68: 78-88
    CrossrefPubMedGoogle Scholar
  • 4 Weusten B, Bisschops R, Coron E. et al. Endoscopic management of Barrett’s esophagus: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2017; 49: 191-198
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Elta GH, Enestvedt BK, Sauer BG. et al. ACG Clinical Guideline: Diagnosis and management of pancreatic cysts. Am J Gastroenterol 2018; 113: 464-479
    CrossrefPubMedGoogle Scholar
  • 6 Pimentel-Nunes P, Libânio D, Marcos-Pinto R. et al. Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019. Endoscopy 2019; 51: 365-388
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Hassan C, Antonelli G, Dumonceau J. et al. Post-polypectomy colonoscopy surveillance: updated European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2020 52. in press
    PubMedGoogle Scholar
  • 8 Beg S, Ragunath K, Wyman A. et al. Quality standards in upper gastrointestinal endoscopy: a position statement of the British Society of Gastroenterology (BSG) and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS). Gut 2017; 66: 1886-1899
    CrossrefPubMedGoogle Scholar
  • 9 Evans JA, Early DS. ASGE Standards of Practice Committee. et al. The role of endoscopy in Barrett’s esophagus and other premalignant conditions of the esophagus. Gastrointest Endosc 2012; 76: 1087-1094
    CrossrefPubMedGoogle Scholar
  • 10 Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol 2013; 108: 308
    CrossrefPubMedGoogle Scholar
  • 11 Fitzgerald RC, di Pietro M, Ragunath K. et al. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett’s oesophagus. Gut 2014; 63: 7-42
    CrossrefPubMedGoogle Scholar
  • 12 Shaheen NJ, Falk GW, Iyer PG. et al. ACG Clinical Guideline: Diagnosis and management of Barrett’s esophagus. Am J Gastroenterol 2016; 111: 30-50; quiz 51
    CrossrefPubMedGoogle Scholar
  • 13 Banks M, Graham D, Jansen M. et al. British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma. Gut 2019; 68: 1545-1575
    CrossrefPubMedGoogle Scholar
  • 14 Standards of Practice Committee. Faulx AL, Kothari S, Acosta RD. et al. The role of endoscopy in subepithelial lesions of the GI tract. Gastrointest Endosc 2017; 85: 1117-1132
    CrossrefPubMedGoogle Scholar
  • 15 ASGE Standards of Practice Committee. Banerjee S, Cash BD, Dominitz JA. et al. The role of endoscopy in the management of patients with peptic ulcer disease. Gastrointest Endosc 2010; 71: 663-668
    CrossrefPubMedGoogle Scholar
  • 16 European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut 2018; 67: 789-804
    CrossrefPubMedGoogle Scholar
  • 17 Rusu R, Ishaq S, Wong T. et al. Cervical inlet patch: new insights into diagnosis and endoscopic therapy. Frontline Gastroenterol 2018; 9: 214-220
    CrossrefPubMedGoogle Scholar
  • 18 Orosey M, Amin M, Cappell MS. A 14-year study of 398 esophageal adenocarcinomas diagnosed among 156,256 EGDs performed at two large hospitals: an inlet patch is proposed as a significant risk factor for proximal esophageal adenocarcinoma. Dig Dis Sci 2018; 63: 452-465
    CrossrefPubMedGoogle Scholar
  • 19 Peitz U, Vieth M, Evert M. et al. The prevalence of gastric heterotopia of the proximal esophagus is underestimated, but preneoplasia is rare – correlation with Barrett’s esophagus. BMC Gastroenterol 2017; 17: 87
    CrossrefPubMedGoogle Scholar
  • 20 Zagari RM, Eusebi LH, Rabitti S. et al. Prevalence of upper gastrointestinal endoscopic findings in the community: A systematic review of studies in unselected samples of subjects. J Gastroenterol Hepatol 2016; 31: 1527-1538
    CrossrefPubMedGoogle Scholar
  • 21 Gyawali CP, Kahrilas PJ, Savarino E. et al. Modern diagnosis of GERD: the Lyon Consensus. Gut 2018; 67: 1351-1362
    CrossrefPubMedGoogle Scholar
  • 22 Muthusamy VR, Lightdale JR, Acosta RD. et al. The role of endoscopy in the management of GERD. Gastrointest Endosc 2015; 81: 1305-1310
    CrossrefPubMedGoogle Scholar
  • 23 Hanna S, Rastogi A, Weston AP. et al. Detection of Barrett’s esophagus after endoscopic healing of erosive esophagitis. Am J Gastroenterol 2006; 101: 1416-1420
    CrossrefPubMedGoogle Scholar
  • 24 Modiano N, Gerson LB. Risk factors for the detection of Barrett’s esophagus in patients with erosive esophagitis. Gastrointest Endosc 2009; 69: 1014-1020
    CrossrefPubMedGoogle Scholar
  • 25 Crockett SD, Lipkus IM, Bright SD. et al. Overutilization of endoscopic surveillance in nondysplastic Barrett’s esophagus: a multicenter study. Gastrointest Endosc 2012; 75: 23-31.e2
    CrossrefPubMedGoogle Scholar
  • 26 Voutilainen M, Färkkilä M, Juhola M. et al. Specialized columnar epithelium of the esophagogastric junction: prevalence and associations. The Central Finland Endoscopy Study Group. Am J Gastroenterol 1999; 94: 913-918
    CrossrefPubMedGoogle Scholar
  • 27 Itskoviz D, Levi Z, Boltin D. et al. Risk of neoplastic progression among patients with an irregular Z line on long-term follow-up. Dig Dis Sci 2018; 63: 1513-1517
    CrossrefPubMedGoogle Scholar
  • 28 Thota PN, Vennalaganti P, Vennelaganti S. et al. Low risk of high-grade dysplasia or esophageal adenocarcinoma among patients with Barrett’s esophagus less than 1 cm (irregular Z line) within 5 years of index endoscopy. Gastroenterology 2017; 152: 987-992
    CrossrefPubMedGoogle Scholar
  • 29 Ko MS, Fung KZ, Shi Y. et al. Barrett’s esophagus commonly diagnosed in elderly men with limited life expectancy. J Am Geriatr Soc 2016; 64: e109-e111
    CrossrefPubMedGoogle Scholar
  • 30 O’Connor A, McNamara D, O’Moráin CA. Surveillance of gastric intestinal metaplasia for the prevention of gastric cancer. Cochrane Database Syst Rev 2013; CD009322
    PubMedGoogle Scholar
  • 31 Mera RM, Bravo LE, Camargo MC. et al. Dynamics of Helicobacter pylori infection as a determinant of progression of gastric precancerous lesions: 16-year follow-up of an eradication trial. Gut 2018; 67: 1239-1246
    CrossrefPubMedGoogle Scholar
  • 32 Aurea P, Grazia M, Petrella F. et al. Giant leiomyoma of the esophagus. Eur J Cardiothorac Surg 2002; 22: 1008-1010
    CrossrefPubMedGoogle Scholar
  • 33 Codipilly DC, Fang H, Alexander JA. et al. Subepithelial esophageal tumors: a single-center review of resected and surveilled lesions. Gastrointest Endosc 2018; 87: 370-377
    CrossrefPubMedGoogle Scholar
  • 34 Trifan A, Târcoveanu E, Danciu M. et al. Gastric heterotopic pancreas: an unusual case and review of the literature. J Gastrointest Liver Dis 2012; 21: 209-212
    PubMedGoogle Scholar
  • 35 Brand B, Oesterhelweg L, Binmoeller KF. et al. Impact of endoscopic ultrasound for evaluation of submucosal lesions in gastrointestinal tract. Dig Liver Dis 2002; 34: 290-297
    CrossrefPubMedGoogle Scholar
  • 36 Ford AC, Gurusamy KS, Delaney B. et al. Eradication therapy for peptic ulcer disease in Helicobacter pylori-positive people. Cochrane Database Syst Rev 2016; 4: CD003840
    CrossrefPubMedGoogle Scholar
  • 37 Tanaka M, Fernández-Del Castillo C, Kamisawa T. et al. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology 2017; 17: 738-753
    CrossrefPubMedGoogle Scholar
  • 38 Vege SS, Ziring B, Jain R. et al. American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology 2015; 148: 819-822; quiz e12-13
    CrossrefPubMedGoogle Scholar
  • 39 Dumonceau J-M, Deprez PH, Jenssen C. et al. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline – Updated January 2017. Endoscopy 2017; 49: 695-714
    Article in Thieme ConnectPubMedGoogle Scholar
  • 40 Zhang X-P, Yu Z-X, Zhao Y-P. et al. Current perspectives on pancreatic serous cystic neoplasms: Diagnosis, management and beyond. World J Gastrointest Surg 2016; 8: 202-211
    CrossrefPubMedGoogle Scholar
  • 41 Day LW, Kwon A, Inadomi JM. et al. Adverse events in older patients undergoing colonoscopy: a systematic review and meta-analysis. Gastrointest Endosc 2011; 74: 885-896
    CrossrefPubMedGoogle Scholar
  • 42 Hassan C, Wysocki PT, Fuccio L. et al. Endoscopic surveillance after surgical or endoscopic resection for colorectal cancer: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Digestive Oncology (ESDO) Guideline. Endoscopy 2019; 51: 266-277
    Article in Thieme ConnectPubMedGoogle Scholar