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

Abstract

In 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. 3 : For esophageal and pancreatic cancer, endoscopic screening may be considered only in high-risk individuals:- FOR SQUAMOUS CELL CARCINOMA: , in those with a personal history of head/neck cancer, achalasia, or previous caustic injury; - FOR BARRETT'S ESOPHAGUS (BE)-ASSOCIATED ADENOCARCINOMA: , in those with long-standing gastroesophageal reflux disease symptoms (i. e., > 5 years) and multiple risk factors (age ≥ 50 years, white race, male sex, obesity, first-degree relative with BE or esophageal adenocarcinoma [EAC]). - FOR PANCREATIC CANCER SCREENING: , endoscopic ultrasound may be used in selected high-risk patients such as those with a strong family history and/or genetic susceptibility.

Conflict of interest statement

R. Bisschops has received research grants from Pentax, Fujifilm, Cook, and Medtronic; he has been/is on advisory boards for Pentax, Fujifilm, Cook, Boston Scientific, Medtronic, and CDX Diagnostic; he has been a speaker for Pentax, Fujifilm, Medtronic, and Medivators; he has received organizational support for educational events from Pentax, and organizational and financial support for educational events from Cook, Boston Scientific, Medtronic, Erbe, and Olympus. E. Dekker has received honoraria from Fujifilm, Olympus, Tillots, and GI Supply, and speaker’s fees from CPP-FAP and Olympus; she is a Co-Editor of Endoscopy journal. H. Messmann has received, in the past 3 years: grants from the Falk Foundation, Olympus, Roche, Bayer, MSD, Novartis, and Amgen; honoraria from the Falk Foundation, Olympus, and Covidien; consultation fees from Lumendi, Boston Scientific, Erbe, and Olympus; and research support from Olympus (ESD-Register). A. Saftoiu has received lecture fees from Pentax Medical Singapore (2016–2019); his department at Ponderas Academic Hospital received 3000 FIT tests (pilot colorectal cancer screening) from Johnson and Johnson (2019–2020). P.D. Siersema is receiving research support from Pentax (2018–2021) and Yakult (2017–2020); his department is receiving research support from The eNose Company (2019–2021); he is Editor-in-Chief of Endoscopy journal. T. Ponchon is providing consultancy to Olympus, Norgine, Ipsen, and Alfa Sigma (from 1 January 2019 to present); his department is receiving research funding from Boston Scientific. J.E. van Hooft has received lecture fees from Medtronics (2014–2015, 2018) and Cook Medical (2019), and consultancy fees from Boston Scientific (2014–2017); her department has received research grants from Cook Medical (2014–2018) and Abbott (2014–2017). G. Antonelli, M. Areia, M.S. Bhutani, E. Bories, R. Capocaccia, I.M. Cazacu, P.H. Deprez, M. Dinis-Ribeiro, C. Hassan, S.P. Pereira, and C. Senore declare no competing interests.

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