Key questions, subgroups and leads
| Question | Lead | Subgroup |
| Diagnosis: overview | ||
| What are the epithelial glandular precancerous lesions of the stomach, what is their prevalence within the UK and what risks do they present? | Dr David Graham | Matthew Banks, Ernst Kuipers, Mario Dinis-Ribeiro, Marnix Jansen, Marco Novelli, Manuel Rodriguez-Justo, Neil Shepherd |
| Are there groups of individuals (without known precancerous lesions) known to be at increased risk of glandular gastric cancer—for example, family history, ethnic origin, genotype and phenotype? | Dr Massimiliano Di Pietro | Matthew Banks, Sergio Coda, David Graham, Noriya Uedo |
| Who should be screened for Helicobacter pylori to reduce gastric cancer and how should they be screened? Does eradication prevent progression to glandular gastric cancer? | Professor Mark Pritchard | Matthew Banks, Takuji Gotoda, Ernst Kuipers, David Graham |
| What blood tests are useful in the management of precancerous gastric lesions? Can they be applied for population screening, monitoring those at risk or those with known lesions? | Dr David Graham | Matthew Banks, Mario Dinis-Ribeiro, Mark Pritchard |
| Diagnosis: endoscopy | ||
| Outside the recommendations within the UK guidelines for the quality of endoscopy, are there further processes that are suggested for the detection and diagnosis of premalignant or early malignant lesions of the stomach? | Professor Takuji Gotoda | Matthew Banks, Krish Ragunath, David Graham, Sergio Coda |
| How does one identify premalignant or early malignant lesions and ensure accurate documentation when reporting? Is a station-based approach beneficial and are there mucosal features that identify these lesions (including recognising the atrophic border)? | Mr Sergio Coda | Matthew Banks, Takuji Gotoda, Noriya Uedo, Pradeep Bhandari, Krish Ragunath, David Graham |
| What biopsy strategy should be adopted for the sampling and reporting of the premalignant or early malignant stomach? Should all those undergoing routine endoscopy be biopsied or are there groups to target? | Dr Marnix Jansen | Matthew Banks, David Graham, Sergio Coda, Marco Novelli, Manuel Rodriguez-Justo, Neil Shepherd |
| What histopathogical and imaging modalities are suggested for the staging of glandular premalignant and early gastric malignant lesions of the stomach? | Mr Sergio Coda | Marnix Jansen, Matthew Banks, David Graham, Sergio Coda, Marco Novelli, Manuel Rodriguez-Justo, Neil Shepherd |
| Surveillance | ||
| Should individuals with premalignant gastric glandular lesions undergo surveillance? If so, what are the recommendations? | Dr Matthew Banks | Mario Dinis-Ribeiro, David Graham, Massimiliano di Pietro, Ernst Kuipers |
| Treatment: endoscopy | ||
| What lesions are amenable for endoscopic removal? How should these lesions be removed? Are there criteria for histopathological assessment that determine prognosis and follow-up? | Professor Pradeep Bhandari | Matthew Banks, Krish Ragunath, Takuji Gotoda, Noriya Uedo, David Graham |
| Treatment: pharmacological | ||
| Is there a role for other pharmacological treatments—for example, cyclo-oxygenase-2 inhibitors and antioxidants? | Dr David Graham | Matthew Banks |
| Screening | ||
| Is there evidence to support the introduction of a population screening programme for glandular gastric cancer? | Dr Matthew Banks | Mark Pritchard, David Graham |
| Gastric polyps | ||
| What are the epithelial gastric polyps and how should they be managed? | Dr Matthew Banks | Sergio Coda, Mark Pritchard, Pradeep Bhandari |
| Research | ||
| Are there recommendations for future research into the diagnosis and management of premalignant and early malignant lesions of the stomach? | Dr Matthew Banks | Marnix Jansen, David Graham |