Thread by @AmerGastroAssn

Gastric intestinal metaplasia (#GIM) is a histological finding which may identify pts at ⬆️ risk for Gastric AdenoCa. Follow our #tweetorial on quality metrics for #GIM management brought to you by the #AGAQuality team

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#AGAQuality team includes: @jenniferKMaratt @Aketwaroo @KennethHung17 @Rajster @VMKGIMD @brownbrij76 @CNewberryMD @David_LeimanMD @ArunJesudian

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Gastric cancer 🔥 facts

3⃣rd leading cause of #cancer death worldwide

May be ⬆️ in persons with specific genetic, environmental and #dietary risk factors

May be ⬇️ when specific testing & endoscopic surveillance strategies are followed

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The most common type of gastric #cancer is intestinal-type, non-cardiac, which is usually associated w chronic #HPylori infection (80% of global burden) via stepwise mucosal changes: nml mucosa ➡️ chronic gastritis ➡️atropic gastritis ➡️ #GIM ➡️ Gastric AdenoCa

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Risk factors for developing gastric #Cancer in pts w/ #GIM:
•Persistent #HPylori infection
•Family history of gastric #cancer
•Incomplete histological subtype
•Extensive #GIM
•Racial/ethnic minorities or immigrants from high incidence regions

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Evidence-based guidelines suggest testing/treating #HPylori in all pts with #GIM and pursuing high quality endoscopic #surveillance exams in some pts. Guidelines like these define trackable #quality metrics. gastrojournal.org/article/S0016-…

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Shared decision-making involving the patient and provider can determine need for #surveillence exams and should include:

✔️Overall gastric cancer risk
✔️Family history
✔️Patient preferences

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If #surveillance biopsies are pursued, they should be taken from specific locations in the #stomach at an interval based on risk

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GIM #AGAQUALITY MEASURE: All pts with #GIM should undergo assessment and eradication of #HPylori which includes confirmation of infection and follow up testing at least 4⃣ weeks after treatment completion

ow.ly/CJRk50IVIGH

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Measure compliance can be tracked using @AmerGastroAssn #AGAQuality measure specifications: gastro.org/wp-content/upl… and flow charts: gastro.org/wp-content/upl…

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#GIM surveillance requires shared #decision making between doctor 👩‍⚕️ and patient 🧑. See more of our best practices for managing GIM in @AmerGastroAssn clinical guidelines gastrojournal.org/article/S0016-…

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Interested to learn more about how @AmerGastroAssn develops #quality measures, what measures are important to track, and get more involved with #AGAQuality? Check out our work: ow.ly/3Zn250IVJrM

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Whoops, we need that edit button. Updated links to these valuable resources:

1⃣ GIM measure specification: gastro.org/wp-content/upl…
2⃣ GIM measure flow chart: gastro.org/wp-content/upl…

10/12 UPDATED