Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative – Update 2025

Miguel Areia; Gianluca Esposito; Philippe Leclercq; Marcin Romańczyk; Jasmin Zessner-Spitzenberg; Pedro G. Delgado Guillena; Ashraf Monged; Raul Honrubia López; Hugo Uchima; Eduardo J. Ruiz Ballesteros; Alba Panarese; Lix Alfredo Reis de Oliveira; Shimaa Afify; Raf Bisschops; Monika Ferlitsch; External Voting Panel

doi:10.1055/a-2674-4912

Endoscopy, Table of Contents

Endoscopy
DOI: 10.1055/a-2674-4912

Position Statement

Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative – Update 2025

Authors

Miguel Areia

¹Gastroenterology Department, Portuguese Oncology Institute of Coimbra (IPO Coimbra), Coimbra, Portugal

²RISE@CI-IPO (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
Gianluca Esposito

³Medical-Surgical Sciences and Translational Medicine Department, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
Philippe Leclercq

⁴Gastroenterology and Hepatology Department, University Hospitals Leuven, Translational Research in Gastrointestinal Disorders (TARGID), Leuven, Belgium
Marcin Romańczyk

⁵Gastroenterology Department, Faculty of Medicine, Academy of Silesia, Katowice, Poland

⁶Endoterapia, H-T. Centrum Medyczne, Tychy, Poland
Jasmin Zessner-Spitzenberg

⁷Gastroenterology and Hepatology Division, Internal Medicine III Department, Medical University of Vienna, Vienna, Austria
Pedro G. Delgado Guillena

⁸Gastroenterology Department, Hospital de Mérida, Badajoz, Spain
Ashraf Monged

⁹Gastroenterology Department, Royal Stoke University Hospital, University Hospitals of North Midlands (UHNM), Stoke-on-Trent, UK
Raul Honrubia López

¹⁰Gastroenterology Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Spain

¹¹Medicine Department, Faculty of Medicine Health and Sports, Universidad Europea de Madrid, Madrid, Spain
Hugo Uchima

¹²Hospital Universitari Germans Trias i Pujol, Badalona, Spain

¹³Teknon Medical Center, Barcelona, Spain
Eduardo J. Ruiz Ballesteros

¹⁴Gastroenterology and Endoscopy Department, Hospital Ángeles Puebla, Puebla, Mexico
Alba Panarese

¹⁵Gastroenterology and Digestive Endoscopy Division, Medical Sciences Department, Central Hospital Azienda Ospedaliera, Taranto, Italy

¹⁶University of Bari Aldo Moro, Taranto, Italy
Lix Alfredo Reis de Oliveira

¹⁷Advanced Endoscopic Center (CEA), Campinas, São Paulo, Brazil
Shimaa Afify

¹⁸Department of Gastroenterology, National Hepatology And Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt
Raf Bisschops

⁴Gastroenterology and Hepatology Department, University Hospitals Leuven, Translational Research in Gastrointestinal Disorders (TARGID), Leuven, Belgium
Monika Ferlitsch

⁷Gastroenterology and Hepatology Division, Internal Medicine III Department, Medical University of Vienna, Vienna, Austria

¹⁹Department of Internal Medicine with Gastroenterology and Geriatrics, Klinik Floridsdorf, Vienna, Austria

External Voting Panel

(

Marianna Arvanitakis

²⁰Department of Gastroenterology, Digestive Oncology and Hepatopancreatology, Erasme Hospital HUB, Brussels, Belgium

Marc Barthet

²¹Hôpital Nord, Marseille, France

Pradeep Bhandari

²²Portsmouth University Hospitals NHS Trust, Portsmouth, UK

Ivo Boskoski

²³Catholic University of Rome, Rome, Italy

²⁴Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

Michael Bretthauer

²⁵University of Oslo, Oslo, Norway

Lorenzo Fuccio

²⁶Department of Medical Sciences and Surgery, University of Bologna, Bologna, Italy

Ian M. Gralnek

²⁷Institute of Gastroenterology and Hepatology, Emek Medical Center, Afula, Israel

Cesare Hassan

²⁸Gastroenterology and Digestive Endoscopy, 'Nuovo Regina Margherita' Hospital, Rome, Italy

Istvan Hritz

²⁹Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary

Vincente Lorenzo-Zúñiga

³⁰Department of Gastroenterology and Endoscopy Unit IISLaFe, University Hospital La Fe, Valencia, Spain

Ioannis S. Papanikolaou

³¹Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece

Enrique Rodríguez de Santiago

³²Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Madrid, Spain

³³Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain

³⁴Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain

Peter D. Siersema

³⁵Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands

Tony C. Tham

³⁶Division of Gastroenterology, Ulster Hospital, Belfast, Northern Ireland

Konstantinos Triantafyllou

³¹Hepatogastroenterology Unit, Second Department of Internal Medicine - Propaedeutic, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece

Andrei Voiosu

³⁷Colentina Clinical Hospital, Bucharest, Romania

)

Abstract

Quality markers and patient experience should be implemented to ensure standardization of practice across upper gastrointestinal (UGI) endoscopy procedures. The set benchmarks ensure high quality procedures are delivered and linked to measurable outcomes. In 2016, the European Society of Gastrointestinal Endoscopy (ESGE), via its Quality Improvement Committee’s UGI Working Group, set a first list of performance measures, including major (key) and minor performance indicators. This paper provides an update on those performance measures, considering the latest literature.

Patients referred for a UGI endoscopy should have an appropriate indication and be fasting for ≥ 2 hours for liquids and ≥ 6 hours for solids.

For a diagnostic UGI endoscopy, patients should have an allocated time slot of ≥ 20 minutes; adequate reporting should include a mucosal visibility score according to one of the available standardized and validated scales; adequate photodocumentation should include relevant normal anatomical landmarks and all abnormal findings; adequate inspection should include the esophagus, stomach, and duodenum, and should last ≥ 7 minutes from intubation to extubation; adequate terminology should include the description of any abnormal finding according to the available standardized and validated classifications.

For patients with nondysplastic Barrett’s esophagus (BE) undergoing surveillance UGI endoscopy, an adequate inspection should take ≥ 1 minute/cm of circumferential extent of Barrett’s epithelium and include the use of chromoendoscopy (acetic acid and/or virtual); biopsies should be taken according to the Seattle protocol.

Adequate inspection for a diagnostic UGI endoscopy in patients with a history of ear, nose, and throat, or lung tumors treated with curative intent should include the use of virtual chromoendoscopy.

Adequate diagnostic UGI endoscopy for patients evaluated for their risk of gastric cancer should include biopsies taken according to the ESGE management of precancerous conditions and lesions in the stomach (MAPS) guideline.

Adequate safety after a therapeutic UGI endoscopy should be assessed by monitoring the incidence of complications.

Patients undergoing a diagnostic UGI endoscopy should have their experience measured using a validated scale, to promote a patient-centered and quality-driven environment.

Patients with nondysplastic BE or gastric precancerous conditions in an endoscopic surveillance program should be monitored for guideline interval adherence.

Full Text

References

References
1 Bisschops R, Areia M, Coron E. et al. Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2016; 48: 843-864
2 Guyatt GH, Oxman AD, Vist GE. et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008; 336: 924-926
3 Bisschops R, Rutter MD, Areia M. et al. Overcoming the barriers to dissemination and implementation of quality measures for gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) position statement. Endoscopy 2021; 53: 196-202
4 Park WG, Shaheen NJ, Cohen J. et al. Quality indicators for EGD. Gastrointest Endosc 2015; 81: 17-30
5 Weusten B, Bisschops R, Dinis-Ribeiro M. et al. Diagnosis and management of Barrett esophagus: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2023; 55: 1124-1146
6 Gralnek IM, Camus Duboc M, Garcia-Pagan JC. et al. Endoscopic diagnosis and management of esophagogastric variceal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2022; 54: 1094-1120
7 Pouw RE, Barret M, Biermann K. et al. Endoscopic tissue sampling – Part 1: Upper gastrointestinal and hepatopancreatobiliary tracts. European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2021; 53: 1174-1188
8 Gralnek IM, Stanley AJ, Morris AJ. et al. Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021. Endoscopy 2021; 53: 300-332
9 Weusten B, Barret M, Bredenoord AJ. et al. Endoscopic management of gastrointestinal motility disorders – part 2: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2020; 52: 600-614
10 Yadlapati R, Early D, Iyer PG. et al. Quality indicators for upper GI endoscopy. Gastrointest Endosc 2025; 101: 236-260
11 Dinis-Ribeiro M, Libanio D, Uchima H. et al. Management of epithelial precancerous conditions and early neoplasia of the stomach (MAPS III): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG) and European Society of Pathology (ESP) Guideline update 2025. Endoscopy 2025; 57: 504-554
12 Black CJ, Paine PA, Agrawal A. et al. British Society of Gastroenterology guidelines on the management of functional dyspepsia. Gut 2022; 71: 1697-1723
13 Maaser C, Sturm A, Vavricka SR. et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis 2019; 13: 144-164
14 Methasate A, Lohsiriwat V. Role of endoscopy in caustic injury of the esophagus. World J Gastrointest Endosc 2018; 10: 274-282
15 Shah R, Davitkov P, Abu Dayyeh BK. et al. AGA Technical Review on intragastric balloons in the management of obesity. Gastroenterology 2021; 160: 1811-1830
16 Tahir M. Appropriateness of upper gastrointestinal endoscopy: will the diagnostic yield improve by the use of American Society of Gastroenterology guidelines?. Euroasian J Hepatogastroenterol 2016; 6: 143-148
17 Rodriguez-de-Santiago E, Frazzoni L, Fuccio L. et al. Digestive findings that do not require endoscopic surveillance – Reducing the burden of care: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2020; 52: 491-497
18 van Tilburg L, van de Ven SEM, de Jonge PJF. et al. Endoscopic screening of the upper gastrointestinal tract for second primary tumors in patients with head and neck cancer in a Western country. Endoscopy 2023; 55: 981-990
19 Pimentel-Nunes P, Libanio D, Bastiaansen BAJ. et al. Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022. Endoscopy 2022; 54: 591-622
20 Deprez PH, Moons LMG, O'Toole D. et al. Endoscopic management of subepithelial lesions including neuroendocrine neoplasms: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2022; 54: 412-429
21 Spaander MCW, van der Bogt RD, Baron TH. et al. Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021. Endoscopy 2021; 53: 751-762
22 Arvanitakis M, Gkolfakis P, Despott EJ. et al. Endoscopic management of enteral tubes in adult patients – Part 1: Definitions and indications. European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2021; 53: 81-92
23 Paspatis GA, Arvanitakis M, Dumonceau JM. et al. Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement – Update 2020. Endoscopy 2020; 52: 792-810
24 Weusten B, Barret M, Bredenoord AJ. et al. Endoscopic management of gastrointestinal motility disorders – part 1: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2020; 52: 498-515
25 Birk M, Bauerfeind P, Deprez PH. et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2016; 48: 489-496
26 Garza K, Aminpour E, Shah J. et al. Glucagon-like peptide-1 receptor agonists increase solid gastric residue rates on upper endoscopy especially in patients with complicated diabetes: a case-control study. Am J Gastroenterol 2024; 119: 1081-1088
27 Cai MX, Gao Y, Li L. et al. Four-hour fasting for semifluids and 2-hour fasting for water improves the patient experience of esophagogastroduodenoscopy: a randomized controlled trial. Gut Liver 2023; 17: 382-388
28 Beg S, Ragunath K, Wyman A. et al. Quality standards in upper gastrointestinal endoscopy: a position statement of the British Society of Gastroenterology (BSG) and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS). Gut 2017; 66: 1886-1899
29 Marin-Gabriel JC, Santiago ER. en representacion de la Asociacion Espanola de Gastroenterologia y la Sociedad Espanola de Endoscopia D. AEG-SEED position paper for the resumption of endoscopic activity after the peak phase of the COVID-19 pandemic. Gastroenterol Hepatol 2020; 43: 389-407
30 De Francesco V, Alicante S, Amato A. et al. Quality performance measures in upper gastrointestinal endoscopy for lesion detection: Italian AIGO-SIED-SIGE joint position statement. Dig Liver Dis 2022; 54: 1479-1485
31 Cho YK. How to improve the quality of screening endoscopy in Korea: National Endoscopy Quality Improvement Program. Clin Endosc 2016; 49: 312-317
32 Chiu PWY, Uedo N, Singh R. et al. An Asian consensus on standards of diagnostic upper endoscopy for neoplasia. Gut 2019; 68: 186-197
33 Nagula S, Parasa S, Laine L. et al. AGA clinical practice update on high-quality upper endoscopy: Expert Review. Clin Gastroenterol Hepatol 2024; 22: 933-943
34 Kaminski MF, Thomas-Gibson S, Bugajski M. et al. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2017; 49: 378-397
35 Bretthauer M, Aabakken L, Dekker E. et al. Requirements and standards facilitating quality improvement for reporting systems in gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2016; 48: 291-294
36 Gralnek IM, Bisschops R, Matharoo M. et al. Guidance for the implementation of a safety checklist for gastrointestinal endoscopic procedures: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement. Endoscopy 2022; 54: 206-210
37 Everett SM, Triantafyllou K, Hassan C. et al. Informed consent for endoscopic procedures: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2023; 55: 952-966
38 Jung S, Kim EH, Kim HY. et al. Factors that affect visibility during endoscopic hemostasis for upper GI bleeding: a prospective study. Gastrointest Endosc 2015; 81: 1392-1400
39 Basford PJ, Brown J, Gadeke L. et al. A randomized controlled trial of pre-procedure simethicone and N-acetylcysteine to improve mucosal visibility during gastroscopy – NICEVIS. Endosc Int Open 2016; 4: E1197-E1202
40 Song M, Kwek AB, Law NM. et al. Efficacy of small-volume simethicone given at least 30 min before gastroscopy. World J Gastrointest Pharmacol Ther 2016; 7: 572-578
41 Elvas L, Areia M, Brito D. et al. Premedication with simethicone and N-acetylcysteine in improving visibility during upper endoscopy: a double-blind randomized trial. Endoscopy 2017; 49: 139-145
42 Sajid MS, Rehman S, Chedgy F. et al. Improving the mucosal visualization at gastroscopy: a systematic review and meta-analysis of randomized, controlled trials reporting the role of Simethicone +/- N-acetylcysteine. Transl Gastroenterol Hepatol 2018; 3: 29
43 Li Y, Du F, Fu D. The effect of using simethicone with or without N-acetylcysteine before gastroscopy: A meta-analysis and systemic review. Saudi J Gastroenterol 2019; 25: 218-228
44 Burke E, Harkins P, Moriarty F. et al. Does premedication with mucolytic agents improve mucosal visualization during oesophagogastroduodenoscopy: a systematic review and meta-analysis. Surg Res Pract 2021; 2021: 1570121
45 Manfredi G, Berte R, Iiritano E. et al. Premedication with simethicone and N-acetylcysteine for improving mucosal visibility during upper gastrointestinal endoscopy in a Western population. Endosc Int Open 2021; 9: E190-E194
46 Khan R, Gimpaya N, Vargas JI. et al. The Toronto Upper Gastrointestinal Cleaning Score: a prospective validation study. Endoscopy 2023; 55: 121-128
47 Cordova H, Barreiro-Alonso E, Castillo-Regalado E. et al. Applicability of the Barcelona scale to assess the quality of cleanliness of mucosa at esophagogastroduodenoscopy. Gastroenterol Hepatol 2024; 47: 246-252
48 Romanczyk M, Ostrowski B, Kozlowska-Petriczko K. et al. Scoring system assessing mucosal visibility of upper gastrointestinal tract: The POLPREP scale. J Gastroenterol Hepatol 2022; 37: 164-168
49 Romanczyk M, Ostrowski B, Lesinska M. et al. The prospective validation of a scoring system to assess mucosal cleanliness during EGD. Gastrointest Endosc 2024; 100: 27-35
50 Romanczyk M, Desai M, Kaminski MF. et al. International validation of a novel PEACE scale to improve the quality of upper gastrointestinal mucosal inspection during endoscopy. Clin Transl Gastroenterol 2025; 16: e00786
51 Esposito G, Dilaghi E, Costa-Santos C. et al. The Gastroscopy RAte of Cleanliness Evaluation (GRACE) Scale: an international reliability and validation study. Endoscopy 2025; 57: 312-320
52 Yao K, Uedo N, Kamada T. et al. Guidelines for endoscopic diagnosis of early gastric cancer. Dig Endosc 2020; 32: 663-698
53 Devereaux BM, Taylor ACF, Athan E. et al. Simethicone use during gastrointestinal endoscopy: Position statement of the Gastroenterological Society of Australia. J Gastroenterol Hepatol 2019; 34: 2086-2089
54 Zuberi BF, Shaikh MA, Ali FS. et al. Effect of pre-endoscopy intake of simethicone solution on endoscopic mucosal visibility: A single blinded, placebo control, randomized trial. Pak J Med Sci 2020; 36: 172-176
55 Chen X, Dai N, Deng Y. et al. Premedication with reformulated simethicone and sodium bicarbonate improves mucosal visibility during upper gastrointestinal endoscopy: a double-blind, multicenter, randomized controlled trial. BMC Gastroenterol 2021; 21: 124
56 Mahawongkajit P, Kanlerd A. A prospective randomized controlled trial comparing simethicone, N-acetylcysteine, sodium bicarbonate and peppermint for visualization in upper gastrointestinal endoscopy. Surg Endosc 2021; 35: 303-308
57 Duez L, Gkolfakis P, Bastide M. et al. Premedication with simethicone for improving the quality of gastric mucosal visualization: a double-blind randomized controlled trial. Endosc Int Open 2022; 10: E1343-E1349
58 Krishnamurthy V, Joseph A, Venkataraman S. et al. Simethicone and N-acetyl cysteine combination as premedication before esophagogastroduodenoscopy: Double-blind randomized controlled trial. Endosc Int Open 2022; 10: E585-E592
59 Stepan M, Fojtik P, Psar R. et al. Administration of maximum dose of mucolytic solution before upper endoscopy – a double-blind, randomized trial. Eur J Gastroenterol Hepatol 2023; 35: 635-640
60 Nabi Z, Vamsi M, Goud R. et al. Pre-medication with simethicone and N-acetyl cysteine for improving mucosal visibility during upper gastrointestinal endoscopy: A randomized controlled trial. Indian J Gastroenterol 2024; 43: 986-994
61 Cao L, Zheng F, Wang D. et al. The effect of using premedication of simethicone/pronase with or without postural change on visualization of the mucosa before endoscopy: a prospective, double blinded, randomized controlled trial. Clin Transl Gastroenterol 2024; 15: e00625
62 Sun X, Xu Y, Zhang X. et al. Simethicone administration improves gastric cleanness for esophagogastroduodenoscopy: a randomized clinical trial. Trials 2021; 22: 555
63 Beaufort IN, Verbeek RE, Bosman JH. et al. Optimal timing of simethicone administration prior to upper endoscopy: A multicenter, single-blind, randomized controlled trial. Endosc Int Open 2023; 11: E992-E1000
64 Fuentes-Valenzuela E, Perez-Arenas E, de Benito Sanz M. et al. Prospective cohort study to evaluate premedication with simethicone and n-acetilcysteine for upper diagnostic gastrointestinal endoscopy. Rev Esp Enferm Dig 2023; 115: 10-15
65 Stepan M, Falt P, Pipek B. et al. Administration of mucolytic solution before upper endoscopy - double-blind, monocentric, randomized study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023; 167: 69-73
66 Liu X, Guan CT, Xue LY. et al. Effect of premedication on lesion detection rate and visualization of the mucosa during upper gastrointestinal endoscopy: a multicenter large sample randomized controlled double-blind study. Surg Endosc 2018; 32: 3548-3556
67 Zhang LY, Li WY, Ji M. et al. Efficacy and safety of using premedication with simethicone/Pronase during upper gastrointestinal endoscopy examination with sedation: A single center, prospective, single blinded, randomized controlled trial. Dig Endosc 2018; 30: 57-64
68 Min JK, Cha JM, Cho YK. et al. Revision of quality indicators for the endoscopy quality improvement program of the national cancer screening program in Korea. Clin Endosc 2018; 51: 239-252
69 Kim SY, Park JM. Quality indicators in esophagogastroduodenoscopy. Clin Endosc 2022; 55: 319-331
70 Emura F, Sharma P, Arantes V. et al. Principles and practice to facilitate complete photodocumentation of the upper gastrointestinal tract: World Endoscopy Organization position statement. Dig Endosc 2020; 32: 168-179
71 Yao K. The endoscopic diagnosis of early gastric cancer. Ann Gastroenterol 2013; 26: 11-22
72 Esposito G, Areia M, Ching H. et al. STAndardization of Reports – The STAR project – Upper Gastrointestinal Endoscopy: A European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2025;
73 Teh JL, Tan JR, Lau LJ. et al. Longer examination time improves detection of gastric cancer during diagnostic upper gastrointestinal endoscopy. Clin Gastroenterol Hepatol 2015; 13: 480-487 e482
74 Kawamura T, Wada H, Sakiyama N. et al. Examination time as a quality indicator of screening upper gastrointestinal endoscopy for asymptomatic examinees. Dig Endosc 2017; 29: 569-575
75 Yoshimizu S, Hirasawa T, Horiuchi Y. et al. Differences in upper gastrointestinal neoplasm detection rates based on inspection time and esophagogastroduodenoscopy training. Endosc Int Open 2018; 6: E1190-E1197
76 Gao Y, Cai MX, Tian B. et al. Setting 6-minute minimal examination time improves the detection of focal upper gastrointestinal tract lesions during endoscopy: a multicenter prospective study. Clin Transl Gastroenterol 2023; 14: e00612
77 Romanczyk M, Romanczyk T, Lesinska M. et al. The relation of esophagogastroduodenoscopy time and novel upper gastrointestinal quality measures. Eur J Gastroenterol Hepatol 2022; 34: 763-768
78 Park JM, Huo SM, Lee HH. et al. Longer observation time increases proportion of neoplasms detected by esophagogastroduodenoscopy. Gastroenterology 2017; 153: 460-469 e461
79 Park JM, Kim SY, Shin GY. et al. Implementation effect of institutional policy of EGD observation time on neoplasm detection. Gastrointest Endosc 2021; 93: 1152-1159
80 Kim SY, Park JM, Cho HS. et al. Assessment of cimetropium bromide use for the detection of gastric neoplasms during esophagogastroduodenoscopy. JAMA Netw Open 2022; 5: e223827
81 Kim HY. Clinical features of gastric adenoma detected within 3 years after negative screening endoscopy in Korea. Gastroenterol Rep (Oxf) 2023; 11: goad039
82 Ishibashi F, Kobayashi K, Fukushima K. et al. Quality indicators for the detection of Helicobacter pylori-negative early gastric cancer: a retrospective observational study. Clin Endosc 2020; 53: 698-704
83 Kim TJ, Pyo JH, Byun YH. et al. Interval advanced gastric cancer after negative endoscopy. Clin Gastroenterol Hepatol 2023; 21: 1205-1213 e1202
84 Correia C, Almeida N, Andrade R. et al. Quality standards in upper gastrointestinal endoscopy: can deep sedation influence it?. GE Port J Gastroenterol 2024; 31: 101-109
85 Meining A, Semmler V, Kassem AM. et al. The effect of sedation on the quality of upper gastrointestinal endoscopy: an investigator-blinded, randomized study comparing propofol with midazolam. Endoscopy 2007; 39: 345-349
86 Antony A, Pohanka C, Keogh S. et al. Adherence to quality indicators in endoscopic surveillance of Barrett's esophagus and correlation to dysplasia detection rates. Clin Res Hepatol Gastroenterol 2018; 42: 591-596
87 Lundell LR, Dent J, Bennett JR. et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999; 45: 172-180
88 Armstrong D. Review article: towards consistency in the endoscopic diagnosis of Barrett's oesophagus and columnar metaplasia. Aliment Pharmacol Ther 2004; 20 (Suppl. 05) 40-47 ; discussion 61–42
89 Forrest JA, Finlayson ND, Shearman DJ. Endoscopy in gastrointestinal bleeding. Lancet 1974; 2: 394-397
90 [Anonymous]. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc 2003; 58: S3-S43
91 de Franchis R, Bosch J, Garcia-Tsao G. et al. Baveno VII – Renewing consensus in portal hypertension. J Hepatol 2022; 76: 959-974
92 Sarin SK, Lahoti D, Saxena SP. et al. Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients. Hepatology 1992; 16: 1343-1349
93 Zargar SA, Kochhar R, Mehta S. et al. The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns. Gastrointest Endosc 1991; 37: 165-169
94 Spigelman AD, Williams CB, Talbot IC. et al. Upper gastrointestinal cancer in patients with familial adenomatous polyposis. Lancet 1989; 2: 783-785
95 Hirano I, Moy N, Heckman MG. et al. Endoscopic assessment of the oesophageal features of eosinophilic oesophagitis: validation of a novel classification and grading system. Gut 2013; 62: 489-495
96 van Rhijn BD, Warners MJ, Curvers WL. et al. Evaluating the endoscopic reference score for eosinophilic esophagitis: moderate to substantial intra- and interobserver reliability. Endoscopy 2014; 46: 1049-1055
97 Kodsi BE, Wickremesinghe C, Kozinn PJ. et al. Candida esophagitis: a prospective study of 27 cases. Gastroenterology 1976; 71: 715-719
98 Hill LD, Kozarek RA, Kraemer SJ. et al. The gastroesophageal flap valve: in vitro and in vivo observations. Gastrointest Endosc 1996; 44: 541-547
99 Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy 2008; 1: 87-97
100 Xiao S, Fan Y, Yin Z. et al. Endoscopic grading of gastric atrophy on risk assessment of gastric neoplasia: A systematic review and meta-analysis. J Gastroenterol Hepatol 2021; 36: 55-63
101 Delgado-Guillena P, Jimeno M, Lopez-Nunez A. et al. The endoscopic model for gastric carcinogenesis and Helicobacter pylori infection: A potential visual mind-map during gastroscopy examination. Gastroenterol Hepatol 2024; 47: 502214
102 Delgado-Guillena PG, Borrallo-Cruz JA, Sanchez-Jara CV. et al. Identifying the gastric atrophic border according to Kimura–Takemoto classification by using high-definition endoscopes and a new virtual chromoendoscopy modality. Gastroenterol Hepatol 2023; 46: 557-559
103 Pimentel-Nunes P, Libanio D, Lage J. et al. A multicenter prospective study of the real-time use of narrow-band imaging in the diagnosis of premalignant gastric conditions and lesions. Endoscopy 2016; 48: 723-730
104 Esposito G, Pimentel-Nunes P, Angeletti S. et al. Endoscopic grading of gastric intestinal metaplasia (EGGIM): a multicenter validation study. Endoscopy 2019; 51: 515-521
105 Marcos P, Brito-Goncalves G, Libanio D. et al. Endoscopic grading of gastric intestinal metaplasia on risk assessment for early gastric neoplasia: can we replace histology assessment also in the West?. Gut 2020; 69: 1762-1768
106 Sharma P, Meining AR, Coron E. et al. Real-time increased detection of neoplastic tissue in Barrett's esophagus with probe-based confocal laser endomicroscopy: final results of an international multicenter, prospective, randomized, controlled trial. Gastrointest Endosc 2011; 74: 465-472
107 Vithayathil M, Modolell I, Ortiz-Fernandez-Sordo J. et al. Image-enhanced endoscopy and molecular biomarkers vs Seattle protocol to diagnose dysplasia in Barrett's esophagus. Clin Gastroenterol Hepatol 2022; 20: 2514-2523 e2513
108 Gupta N, Gaddam S, Wani SB. et al. Longer inspection time is associated with increased detection of high-grade dysplasia and esophageal adenocarcinoma in Barrett's esophagus. Gastrointest Endosc 2012; 76: 531-538
109 Vithayathil M, Modolell I, Ortiz-Fernandez-Sordo J. et al. The effect of procedural time on dysplasia detection rate during endoscopic surveillance of Barrett's esophagus. Endoscopy 2023; 55: 491-498
110 Beg S, Mensa M, Fullard M. et al. Impact of advanced endoscopic imaging on Barrett's esophagus in daily clinical practice. Gastrointest Endosc 2018; 87: 1189-1194
111 Sharma P, Hawes RH, Bansal A. et al. Standard endoscopy with random biopsies versus narrow band imaging targeted biopsies in Barrett's oesophagus: a prospective, international, randomised controlled trial. Gut 2013; 62: 15-21
112 Elsheaita A, El-Bially MA, Shamseya MM. et al. Seattle protocol vs narrow band imaging guided biopsy in screening of Barrettʼs esophagus in gastroesophageal reflux disease patients. Medicine (Baltimore) 2020; 99: e19261
113 Wolfsen HC, Crook JE, Krishna M. et al. Prospective, controlled tandem endoscopy study of narrow band imaging for dysplasia detection in Barrett's Esophagus. Gastroenterology 2008; 135: 24-31
114 Qumseya BJ, Wang H, Badie N. et al. Advanced imaging technologies increase detection of dysplasia and neoplasia in patients with Barrett's esophagus: a meta-analysis and systematic review. Clin Gastroenterol Hepatol 2013; 11: 1562-1570 e1561–1562
115 Zhang N, Li Y, Chang X. et al. Long-term effectiveness of one-time endoscopic screening for esophageal cancer: A community-based study in rural China. Cancer 2020; 126: 4511-4520
116 Overwater A, Rueb K, Elias SG. et al. Esophageal second primary tumors in patients with head and neck squamous cell carcinoma: incidence, risk factors, and overall survival. Am J Gastroenterol 2022; 117: 794-797
117 Morita FH, Bernardo WM, Ide E. et al. Narrow band imaging versus lugol chromoendoscopy to diagnose squamous cell carcinoma of the esophagus: a systematic review and meta-analysis. BMC Cancer 2017; 17: 54
118 Gruner M, Denis A, Masliah C. et al. Narrow-band imaging versus Lugol chromoendoscopy for esophageal squamous cell cancer screening in normal endoscopic practice: randomized controlled trial. Endoscopy 2021; 53: 674-682
119 Chaber-Ciopinska A, Kiprian D, Wieszczy P. et al. Narrow-band imaging vs Lugol chromoendoscopy in screening for esophageal squamous cell neoplasia: a randomized trial. Pol Arch Intern Med 2023; 133: 16462
120 Kolb JM, Davis C, Williams JL. et al. Wide variability in dysplasia detection rate and adherence to Seattle protocol and surveillance recommendations in Barrett's esophagus: a population-based analysis using the GIQuIC National Quality Benchmarking Registry. Am J Gastroenterol 2023; 118: 900-904
121 Roumans CAM, van der Bogt RD, Steyerberg EW. et al. Adherence to recommendations of Barrett's esophagus surveillance guidelines: a systematic review and meta-analysis. Endoscopy 2020; 52: 17-28
122 Abrams JA, Kapel RC, Lindberg GM. et al. Adherence to biopsy guidelines for Barrettʼs esophagus surveillance in the community setting in the United States. Clin Gastroenterol Hepatol 2009; 7: 736-742 ; quiz 710
123 Abela JE, Going JJ, Mackenzie JF. et al. Systematic four-quadrant biopsy detects Barrett's dysplasia in more patients than nonsystematic biopsy. Am J Gastroenterol 2008; 103: 850-855
124 Beaufort I, Akkerman E, van Munster S. et al. Effect of biopsy protocol adherence vs non-adherence on dysplasia detection rates in Barrett's esophagus surveillance endoscopies: a systematic review and meta-analysis. Endosc Int Open 2023; 11: E221-E229
125 Areia M, Spaander MC, Kuipers EJ. et al. Endoscopic screening for gastric cancer: A cost-utility analysis for countries with an intermediate gastric cancer risk. United European Gastroenterol J 2018; 6: 192-202
126 Libanio D, Antonelli G, Marijnissen F. et al. Combined gastric and colorectal cancer endoscopic screening may be cost-effective in Europe with the implementation of artificial intelligence: an economic evaluation. Eur J Gastroenterol Hepatol 2024; 36: 155-161
127 Garces-Duran R, Galdin-Ferreyra M, Delgado-Guillena PG. et al. Diagnosis of Helicobacter pylori infection by the arrangement of collecting venules using white light endoscopy: evaluation of interobserver agreement. Dig Dis 2022; 40: 376-384
128 Uchima H, Yao K. Endoscopic microanatomy of the normal gastrointestinal mucosa with narrow band technology and magnification. Gastroenterol Hepatol 2019; 42: 117-126
129 Uedo N, Yao K. Endoluminal diagnosis of early gastric cancer and its precursors: bridging the gap between endoscopy and pathology. Adv Exp Med Biol 2016; 908: 293-316
130 Lenti MV, Rugge M, Lahner E. et al. Autoimmune gastritis. Nat Rev Dis Primers 2020; 6: 56
131 Toyoshima O, Nishizawa T, Koike K. Endoscopic Kyoto classification of Helicobacter pylori infection and gastric cancer risk diagnosis. World J Gastroenterol 2020; 26: 466-477
132 Takeda T, Asaoka D, Nojiri S. et al. Linked Color Imaging and the Kyoto classification of gastritis: evaluation of visibility and inter-rater reliability. Digestion 2020; 101: 598-607
133 Ishikawa T, Matsumura T, Okimoto K. et al. Efficacy of texture and color enhancement imaging in visualizing gastric mucosal atrophy and gastric neoplasms. Sci Rep 2021; 11: 6910
134 Kamada T, Maruyama Y, Monobe Y. et al. Endoscopic features and clinical importance of autoimmune gastritis. Dig Endosc 2022; 34: 700-713
135 Delgado-Guillena P, Vinagre-Rodriguez G, Gutierrez-Cierco JL. et al. Gastric intestinal metaplasia with a novel high-definition endoscopic system and optical and digital chromoendoscopy. Gastroenterol Hepatol 2022; 45: 286-288
136 Rodriguez-Carrasco M, Esposito G, Libanio D. et al. Image-enhanced endoscopy for gastric preneoplastic conditions and neoplastic lesions: a systematic review and meta-analysis. Endoscopy 2020; 52: 1048-1065
137 Shu X, Wu G, Zhang Y. et al. Diagnostic value of linked color imaging based on endoscopy for gastric intestinal metaplasia: a systematic review and meta-analysis. Ann Transl Med 2021; 9: 506
138 Uedo N, Ishihara R, Iishi H. et al. A new method of diagnosing gastric intestinal metaplasia: narrow-band imaging with magnifying endoscopy. Endoscopy 2006; 38: 819-824
139 An JK, Song GA, Kim GH. et al. Marginal turbid band and light blue crest, signs observed in magnifying narrow-band imaging endoscopy, are indicative of gastric intestinal metaplasia. BMC Gastroenterol 2012; 12: 169
140 Kawamura M, Uedo N, Koike T. et al. Kyoto classification risk scoring system and endoscopic grading of gastric intestinal metaplasia for gastric cancer: Multicenter observation study in Japan. Dig Endosc 2022; 34: 508-516
141 Toyoshima O, Nishizawa T. Kyoto classification of gastritis: Advances and future perspectives in endoscopic diagnosis of gastritis. World J Gastroenterol 2022; 28: 6078-6089
142 Castro R, Esposito G, Libanio D. et al. A single vial is enough in the absence of endoscopic suspected intestinal metaplasia – less is more!. Scand J Gastroenterol 2019; 54: 673-677
143 Lage J, Pimentel-Nunes P, Figueiredo PC. et al. Light-NBI to identify high-risk phenotypes for gastric adenocarcinoma: do we still need biopsies?. Scand J Gastroenterol 2016; 51: 501-506
144 Delgado-Guillena PG, Morales-Alvarado VJ, Elosua-Gonzalez A. et al. Gastroenterologists' attitudes on the detection and management of gastric premalignant conditions: results of a nationwide survey in Spain. Eur J Cancer Prev 2021; 30: 431-436
145 Yip HC, Uedo N, Chan SM. et al. An international survey on recognition and characterization of atrophic gastritis and intestinal metaplasia. Endosc Int Open 2020; 8: E1365-E1370
146 Latorre G, Vargas JI, Shah SC. et al. Implementation of the updated Sydney system biopsy protocol improves the diagnostic yield of gastric preneoplastic conditions: Results from a real-world study. Gastroenterol Hepatol 2024; 47: 793-803
147 Ishihara R, Arima M, Iizuka T. et al. Endoscopic submucosal dissection/endoscopic mucosal resection guidelines for esophageal cancer. Dig Endosc 2020; 32: 452-493
148 Zhao Y, Wang C. Long-term clinical efficacy and perioperative safety of endoscopic submucosal dissection versus endoscopic mucosal resection for early gastric cancer: an updated meta-analysis. Biomed Res Int 2018; 2018: 3152346
149 Perez-Cuadrado-Robles E, Queneherve L, Margos W. et al. ESD versus EMR in non-ampullary superficial duodenal tumors: a systematic review and meta-analysis. Endosc Int Open 2018; 6: E998-E1007
150 Yang D, Zou F, Xiong S. et al. Endoscopic submucosal dissection for early Barrett's neoplasia: a meta-analysis. Gastrointest Endosc 2018; 87: 1383-1393
151 Han C, Sun Y. Efficacy and safety of endoscopic submucosal dissection versus endoscopic mucosal resection for superficial esophageal carcinoma: a systematic review and meta-analysis. Dis Esophagus 2021; 34: doaa081
152 Ding X, Luo H, Duan H. Risk factors for perforation of gastric endoscopic submucosal dissection: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2019; 31: 1481-1488
153 Bettenworth D, Mucke MM, Lopez R. et al. Efficacy of endoscopic dilation of gastroduodenal Crohn's disease strictures: a systematic review and meta-analysis of individual patient data. Clin Gastroenterol Hepatol 2019; 17: 2514-2522 e2518
154 Bush N, Bhattacharjee S, Sachan A. et al. Perforations from endoscopic dilation of corrosive strictures in adults: a systematic review and meta-analysis. Dig Dis Sci 2022; 67: 3200-3209
155 Dasari CS, Jegadeesan R, Patel HK. et al. Intralesional steroids and endoscopic dilation for anastomotic strictures after esophagectomy: systematic review and meta-analysis. Endoscopy 2020; 52: 721-726
156 Illes A, Farkas N, Hegyi P. et al. Is Heller myotomy better than balloon dilation? A meta-analysis. J Gastrointestin Liver Dis 2017; 26: 121-127
157 Wang C, Wei H, Li Y. Comparison of fully-covered vs partially covered self-expanding metallic stents for palliative treatment of inoperable esophageal malignancy: a systematic review and meta-analysis. BMC Cancer 2020; 20: 73
158 Kamarajah SK, Bundred J, Spence G. et al. Critical appraisal of the impact of oesophageal stents in the management of oesophageal anastomotic leaks and benign oesophageal perforations: an updated systematic review. World J Surg 2020; 44: 1173-1189
159 Gkolfakis P, Arvanitakis M, Despott EJ. et al. Endoscopic management of enteral tubes in adult patients – Part 2: Peri- and post-procedural management. European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2021; 53: 178-195
160 Hedjoudje A, Abu Dayyeh BK, Cheskin LJ. et al. Efficacy and safety of endoscopic sleeve gastroplasty: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2020; 18: 1043-1053 e1044
161 Waddingham W, Kamran U, Kumar B. et al. Complications of diagnostic upper Gastrointestinal endoscopy: common and rare – recognition, assessment and management. BMJ Open Gastroenterol 2022; 9: e000688
162 Nass KJ, Zwager LW, van der Vlugt M. et al. Novel classification for adverse events in GI endoscopy: the AGREE classification. Gastrointest Endosc 2022; 95: 1078-1085 e1078
163 Crispino F, Merola E, Tasini E. et al. Adverse events in gastrointestinal endoscopy: Validation of the AGREE classification in a real-life 5-year setting. Dig Liver Dis 2023; 55: 933-937
164 Osborne JM, Wilson C, Duncan A. et al. Patterns of participation over four rounds of annual fecal immunochemical test-based screening for colorectal cancer: what predicts rescreening?. BMC Public Health 2017; 18: 81
165 Loftus R, Nugent Z, Graff LA. et al. Patient satisfaction with the endoscopy experience and willingness to return in a central Canadian health region. Can J Gastroenterol 2013; 27: 259-266
166 Brown S, Bevan R, Rubin G. et al. Patient-derived measures of GI endoscopy: a meta-narrative review of the literature. Gastrointest Endosc 2015; 81: 1130-1140 e1131–1139
167 Johanson JF, Schmitt CM, Deas Jr. TM. et al. Quality and outcomes assessment in Gastrointestinal Endoscopy. Gastrointest Endosc 2000; 52: 827-830
168 Hutchings HA, Cheung WY, Alrubaiy L. et al. Development and validation of the Gastrointestinal Endoscopy Satisfaction Questionnaire (GESQ). Endoscopy 2015; 47: 1137-1143
169 Neilson LJ, Sharp L, Patterson JM. et al. The Newcastle ENDOPREM: a validated patient reported experience measure for gastrointestinal endoscopy. BMJ Open Gastroenterol 2021; 8: 1-8
170 Yacavone RF, Locke 3rd GR, Gostout CJ. et al. Factors influencing patient satisfaction with GI endoscopy. Gastrointest Endosc 2001; 53: 703-710
171 Vargo J, Howard K, Petrillo J. et al. Development and validation of the patient and clinician sedation satisfaction index for colonoscopy and upper endoscopy. Clin Gastroenterol Hepatol 2009; 7: 156-162
172 Leffler DA, Bukoye B, Sawhney M. et al. Development and validation of the PROcedural Sedation Assessment Survey (PROSAS) for assessment of procedural sedation quality. Gastrointest Endosc 2015; 81: 194-203 e191
173 Ko HH, Zhang H, Telford JJ. et al. Factors influencing patient satisfaction when undergoing endoscopic procedures. Gastrointest Endosc 2009; 69: 883-891 , quiz 891 e881
174 Lin OS, Schembre DB, Ayub K. et al. Patient satisfaction scores for endoscopic procedures: impact of a survey-collection method. Gastrointest Endosc 2007; 65: 775-781
175 Harewood GC, Yacavone RF, Locke GR. et al. Prospective comparison of endoscopy patient satisfaction surveys: e-mail versus standard mail versus telephone. Am J Gastroenterol 2001; 96: 3312-3317
176 Wong E, Mavondo F, Fisher J. Patient feedback to improve quality of patient-centred care in public hospitals: a systematic review of the evidence. BMC Health Serv Res 2020; 20: 530
177 Reeves R, West E, Barron D. Facilitated patient experience feedback can improve nursing care: a pilot study for a phase III cluster randomised controlled trial. BMC Health Serv Res 2013; 13: 259
178 Hydes T, Yusuf A, Pearl DS. et al. A survey of patients' attitudes to upper gastrointestinal endoscopy identifies the value of endoscopist-patient interactive factors. Frontline Gastroenterol 2011; 2: 242-248
179 Rostom A, Ross ED, Dube C. et al. Development and validation of a nurse-assessed patient comfort score for colonoscopy. Gastrointest Endosc 2013; 77: 255-261
180 Broder E, Davies A, Alrubaiy L. Using information videos to improve patient satisfaction in endoscopy: a prospective service improvement project. Cureus 2022; 14: e24108
181 Barry MJ, Edgman-Levitan S. Shared decision making--pinnacle of patient-centered care. NEJM 2012; 366: 780-781
182 van Munster SN, Verheij EPD, Ozdemir O. et al. Incidence and prediction of unrelated mortality after successful endoscopic eradication therapy for Barrett's neoplasia. Gastroenterology 2024; 166: 1058-1068
183 Dhaliwal L, Codipilly DC, Gandhi P. et al. Neoplasia detection rate in Barrett's esophagus and its impact on missed dysplasia: results from a large population-based database. Clin Gastroenterol Hepatol 2021; 19: 922-929 e921
184 Codipilly DC, Chandar AK, Singh S. et al. The effect of endoscopic surveillance in patients with Barrett's esophagus: a systematic review and meta-analysis. Gastroenterology 2018; 154: 2068-2086 e2065
185 Bornschein J, Tran-Nguyen T, Fernandez-Esparrach G. et al. Biopsy sampling in upper gastrointestinal endoscopy: a survey from 10 tertiary referral centres across Europe. Dig Dis 2021; 39: 179-189
186 Cotruta B, Gheorghe C, Iacob R. et al. The orientation of gastric biopsy samples improves the inter-observer agreement of the OLGA staging system. J Gastrointestin Liver Dis 2017; 26: 351-356
187 Rugge M, Meggio A, Pennelli G. et al. Gastritis staging in clinical practice: the OLGA staging system. Gut 2007; 56: 631-636
188 Capelle LG, de Vries AC, Haringsma J. et al. The staging of gastritis with the OLGA system by using intestinal metaplasia as an accurate alternative for atrophic gastritis. Gastrointest Endosc 2010; 71: 1150-1158
189 Yue H, Shan L, Bin L. The significance of OLGA and OLGIM staging systems in the risk assessment of gastric cancer: a systematic review and meta-analysis. Gastric Cancer 2018; 21: 579-587
190 Banks M, Graham D, Jansen M. et al. British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma. Gut 2019; 68: 1545-1575
191 Delgado-Guillena P, Velamazan-Sandalinas R, Jimenez Sanchez J. et al. History and clinical guidelines for chronic atrophic gastritis and the assessment of gastric cancer risk. Gastroenterol Hepatol 2023; 46: 727-731
192 Kamran U, Evison F, Morris EJA. et al. The variation in post-endoscopy upper gastrointestinal cancer rates among endoscopy providers in England and associated factors: a population-based study. Endoscopy 2025; 57: 17-28

Supplementary Material

Supplementary material (PDF)