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

Abstract

OF STATEMENTSIn 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. Săftoiu Adrian et al. Role of gastrointestinal … Endoscopy 2020; 52: 293-304

Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2020

“…Stopping post-polypectomy surveillance CRC screening is generally recommended until 74 years of age because of its limited efficacy after this age due to competing causes of death [110]. Taking into consideration the 3-year interval for first surveillance, a patient would still undergo the first surveillance colonoscopy before the limit of 80 years.…”

A risk-stratified approach to colorectal cancer prevention and diagnosis

“…For example, in the USA, Germany and Poland, screening is colonoscopy based but ‘opportunistic’ rather than population centred 60 . Guidelines by the European Society of Gastrointestinal Endoscopy recommend FIT-based screening 61 . Screening programmes are consistently focused on age 60 .…”

COVID-19 and endoscopy: implications for healthcare and digestive cancer screening

“…With the outbreak of COVID-19, many countries with population-based CRC screening programmes have suspended inviting individuals for faecal occult blood testing (FOBT; for example, guaiac-based or immunochemical-based tests) and/or endoscopy-based screening 3 . Depending on how long social and physical distancing and other viral spread mitigation rules continue to be in place, the lack of primary screening for CRC might affect millions of individuals worldwide, both at average and high risk.…”

“…In areas of the world at intermediate and high risk of gastric cancer (for example, Asia or select parts of Europe), gastric cancer screening using upper gastrointestinal endoscopy identifies individuals with extensive COVID-19 and endoscopy: implications for healthcare and digestive cancer screening Ian M. Gralnek 1,2 ✉ , Cesare Hassan 3 and Mario Dinis-Ribeiro 4,5 The coronavirus disease 2019 (COVID-19) pandemic is affecting and changing the daily practice of gastrointestinal endoscopy worldwide. To protect patients and endoscopy unit personnel, endoscopy units have had to postpone a large proportion of endoscopic procedures.…”