Protocolos de prevención y diagnóstico precoz de los tumores digestivos I: adenocarcinoma de esófago y estómago

Abstract

Barrett's esophagus is considered a preneoplastic entity with low risk of progression to esophageal adenocarcinoma, which should be ruled out in the presence of risk factors. Once detected, maintenance treatment with proton pump inhibitors is recommended, so as to minimize exposure to gastric acid reflux, as well as endoscopic follow-up, the frequency of which will depend on the degree of extension of Barrett's esophagus.

Gastric adenocarcinoma is the fifth most frequent cancer worldwide. Strategies have been developed to facilitate an early diagnosis and reduce its incidence. However, population screening in areas with a low incidence is not recommended. Chronic atrophic gastritis and intestinal metaplasia are considered preneoplastic lesions because they may possibly progress to the development of dysplasia and adenocarcinoma. The main cause of chronic gastritis is chronic Helicobacter pylori infection. Eradication is recommended if it is detected, as is endoscopic surveillance if follow-up criteria are met. Finally, if dysplasia or early carcinoma is found during screening, endoscopic treatment is recommended if a visible lesion is identified.