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There is much more to rely on histology than the sole endoscopy tells us
  1. Matteo Ghisa1,
  2. Massimo Rugge2,
  3. Matteo Fassan2,
  4. Fabio Farinati1,
  5. Edoardo Savarino1
  1. 1Department of Surgery, Oncology and Gastroenterology (DISCOG), Gastroenterology Unit, University of Padova-Azienda Ospedaliera di Padova, Padova, Italy
  2. 2Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padova-Azienda Ospedaliera di Padova, Padova, Italy
  1. Correspondence to Dr Edoardo Savarino, Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova 35122, Italy; esavarino{at}libero.it

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We read with great interest the article by Banks and coworkers, who presented the British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric carcinoma (GC).1 This work exhaustively provides statements and recommendations on the prevalence, risk factors, diagnosis and management of gastric premalignant lesions (ie, gastric atrophy (GA) and gastric intestinal metaplasia (GIM)) as well as early gastric cancer. Relevant suggestions for improving our clinical practice were made; however, some data have been underestimated and given the lack of useful predictors of cancer progression, we believe they are important to emphasise.

In these guidelines GA and GIM are grouped as chronic atrophic gastritis (CAG), which was staged based on its extension in the antrum-incisura or even …

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