ASGE Issues Guidelines Addressing Ethnicity, GI Diseases and Endoscopy

The American Society for Gastrointestinal Endoscopy has issued guidelines addressing ethnicity, gastrointestinal diseases and endoscopic procedures, according to an ASGE news release. The guidelines, developed by the ASGE's Standards of Practice Committee, appear in the June issue of GIE: Gastrointestinal Endoscopy.

"This guideline is not intended to serve as a comprehensive list of gastrointestinal disease profiles for various ethnic groups. Colorectal cancer screening is one example where practice recommendations have been modified to account for differences based on patient ethnicity. Studies addressing the impact of modifying specific endoscopic standards of practice for conditions based on ethnicity are currently lacking," Jason A. Dominitz, MD, MHS, FASGE, chair of ASGE's Standards of Practice Committee, said in the release. "However, it is logical to assume that increased awareness of differences in disease patterns and management among different ethnic groups could have beneficial impacts on the health-related quality of life of people in these groups. At the same time, it is important to recognize that ethnic populations are not homogeneous and that additional factors, such as environment and behavior, also play important roles in disease."

The recommendations were made base on reviewed studies and aggregate evidence quality and an assessment of anticipated benefits and harms, according to the release. Weaker recommendations are indicated by phrases such as "we suggest," whereas stronger recommendations are typically stated as "we recommend."

The ASGE's guidelines are as follows:

1.    We suggest that screening EGD or upper endoscopy for adenocarcinoma or squamous cell carcinoma of the esophagus should be based on clinical considerations and not upon ethnicity.
2.    Screening for and treating Helicobacter pylori has the potential to reduce the risk for gastric cancer in groups with high gastric cancer risk, but we do not suggest ethnicity based deviations from usual care.
3.    In patients found to have gastric intestinal metaplasia, we suggest surveillance for those at increased risk of gastric cancer due to ethnic background or family history.
4.    We suggest screening EGD for gastric cancer in new U.S. immigrants from high-risk regions around the world, such as Korea, Japan, China, Russia and South America, especially if there is a family history of gastric cancer in a first-degree relative.
5.    We suggest that colorectal cancer screening should commence at age 45 for average-risk African-American men and women.
6.    We recommend that colorectal cancer screening be emphasized for other minority ethnic groups that have lower screening utilization rates.

The full guideline can be found in the June issue of GIE at www.giejournal.org or on ASGE's website.

Read the ASGE's release on ethnicity and endoscopy (pdf).