Materiały źródłowe

• #1 Gastric Polyps: A Review of Clinical, Endoscopic, and Histopathologic Features and Management Decisions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3992058/

  The increasing use of endoscopy has led to more discernable abnormalities in the stomach, including polyps. […] Despite their high prevalence, there is a paucity of literature to support management and treatment decisions for endoscopists. […] Gastric polyps most frequently originate in the mucosa but encompass a broad spectrum of pathologic conditions that may even be submucosal or extrinsic. […] Found in 6% of upper endoscopies, gastric polyps are a heterogeneous group of epithelial and subepithelial lesions that can vary in histology, neoplastic potential, and management. […] Most have no risk of cancer, but there are certain subsets of polyps with malignant potential, necessitating further endoscopic treatment and/or periodic surveillance. […] The recommendations for initial management and follow-up should be followed at the discretion of the endoscopist.

• #2 Gastric Polyp – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560704/

  Gastric polyps are found during 6% of EGDs. Sporadic fundic gland polyps represent 37% to 77% of all gastric polyps and are most common in middle-aged women. Hyperplastic polyps are the second most common, reported between 17% and 42% of cases, and gastric adenomas 0.5 % to 1%. Malignancy is found in 1% to 2% of polyploid gastric lesions. […] The prevalence of H pylori has decreased with a concomitant decline in peptic ulcer disease and hyperplastic polyps. Gastroesophageal reflux is the most common pathology noted at endoscopy, with an associated increase in esophageal cancer, cancer of the cardia, and an increase in eosinophilic esophagitis. Gastric adenoma, historically seen more frequently in countries with a high gastric cancer rate, such as China, may be found in up to 10% of gastric polyps in Asian countries and is increasing in Western countries.

• #3 Gastric polyps – UpToDate

  https://www.uptodate.com/contents/gastric-polyps

  Gastric polyps are found in approximately 6 percent of upper gastrointestinal endoscopic procedures in the United States. However, lower rates have been reported in other countries. Hyperplastic polyps and adenomas are relatively more prevalent as compared with fundic gland polyps in regions where Helicobacter pylori infection is common. In contrast, in Western countries, where the prevalence of H. pylori infection is lower and proton pump inhibitor (PPI) use is common, the most commonly encountered polyps are fundic gland polyps. […] This topic will review the epidemiology, clinical manifestations, histopathology, and management of gastric polyps.

• #4 Gastric polyps: a 10-year analysis of 18,496 upper endoscopies | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-022-02154-8

  Gastric polyps (GPs) are usually asymptomatic lesions of the upper gastrointestinal tract observed in 13% of esophagogastroduodenoscopies (EGD). Most GPs are benign. The aim of this study was to precise the frequency of different types of gastric polyps in our population, and to analyze their possible association with other factors. […] GPs were found in 86 out of 18,496 (0.46%) reviewed EGD, corresponding to a total of 141 polyps. […] The most common location was the fundus (59.6%) and 48.9% were smaller than 5 mm. […] According to Paris classification, 80% of the polyps were sessile (Is). Hyperplastic polyps were the most common (55.9%), followed by sporadic fundic gland polyps observed in 23 patients (18.1%), 7 (5.5%) were adenomas and 4 (3.1%) were neuroendocrine tumors type 1. […] The following factors were associated with hyperplastic polyps: anemia (p=0.022), single polyp (p=0.025) and size5 mm (p=0.048).

• #5 Gastric Polyps | Oncohema Key

  https://oncohemakey.com/gastric-polyps/

  Regarding prevalence, retrospective reviews of endoscopic reports are likely to underestimate the true rates, because all polyps are typically not excised and characterized, while prospective evaluations are necessarily limited to relatively small numbers of patients in single institutions, with resulting population and expertise biases. […] These pitfalls must be kept in mind when interpreting the prevalence data in Table 21-1.

• #6 Pathophysiological and clinical aspects of gastric hyperplastic polyps

  https://www.wjgnet.com/1007-9327/full/v22/i40/8883.htm

  Gastric polyps become a major clinical problem because of high prevalence and tendency to malignant transformation of some of them. […] Gastric polyps are detected during 1%-6% of upper gastrointestinal endoscopies and in 0.1%-0.8% of autopsies. […] According to the macroscopic classification of Yamada and Ichikawa, polyps can be divided into: 1/flat polyps, 2/sessile polyps, 3/semi-pedunculated polyps, 4/pedunculated polyps. […] Gastric hyperplastic polyps (GHPs) can be single (68%-75%) or multiple, they occur sporadically (isolated polyps) or as a component of a rare hyperplastic polyposis syndrome. […] The incidence of GHPs increases with age and although they can also be found in children, GHPs usually affects the 65-75 year-old population. […] Most studies proved higher incidence of all types of gastric polyps in women than in men.

• #7 Gastric Polyps | 5-Minute Clinical Consult

  https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816418/8/Gastric_Polyps

  Incidence ~6% in the United States (1) […] Prevalence varies worldwide, estimated to be ~4% in United States. Fundic gland polyps (often arising in the setting of long-term proton pump inhibitor [PPI] use) are the dominant type. […] 2/3 of gastric polyps are in patients 60 years old. […] Gastric polyps are common in both children and adults with familial adenomatous polyposis (FAP) syndrome. Most often, these are fundic gland polyps.

• #8 Gastric Polyps: A Review of Clinical, Endoscopic, and Histopathologic Features and Management Decisions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3992058/

  The increasing use of endoscopy has led to more discernable abnormalities in the stomach, including polyps. […] Despite their high prevalence, there is a paucity of literature to support management and treatment decisions for endoscopists. […] Gastric polyps most frequently originate in the mucosa but encompass a broad spectrum of pathologic conditions that may even be submucosal or extrinsic. […] Found in 6% of upper endoscopies, gastric polyps are a heterogeneous group of epithelial and subepithelial lesions that can vary in histology, neoplastic potential, and management. […] Most have no risk of cancer, but there are certain subsets of polyps with malignant potential, necessitating further endoscopic treatment and/or periodic surveillance. […] The recommendations for initial management and follow-up should be followed at the discretion of the endoscopist.

• #9 Gastric Polyps Detected Incidentally during Gastroscopy and Follow-Up Results

  https://www.mdpi.com/2077-0383/13/11/3117

  The epidemiology of gastritis, gastric atrophy, and gastric lesions associated with increased acid imbalance has undergone significant changes, and the frequency of polyps is thought to be increasing. […] Over 90% of polyps are asymptomatic and may be found incidentally. […] Although typical appearances of some types of polyps can be seen using endoscopy, a histological evaluation is required to determine the presence of dysplasia. Therefore, a polypectomy should be performed for all gastric polyps to assess the pre-malignancy risk. […] The relationship between stomach polyps and colon cancer is an important one due to its frequency. A study conducted in 2013 showed that the presence of concurrent colonic neoplasias increased in patients with gastric adenoma or cancer, and a pre-treatment screening colonoscopy is recommended.

• #10 Gastroenterology Education and CPD for trainees and specialists » Gastric polyps

  https://www.gastrotraining.com/gastric-polyps

  Gastric polyps are mostly asymptomatic (90%) and are typically found incidentally at OGD. Larger polyps can present with bleeding, anemia, abdominal pain or gastric outlet obstruction. […] Majority of gastric polyps are hyperplastic in nature (30-93%). […] Hyperplastic polyps should be biopsied and an examination of the whole stomach should be made for mucosal abnormalities and any abnormalities biopsied. Hyperplastic polyps rarely undergo neoplastic transformation; however there is an increased risk of neoplasia in the surrounding abnormal gastric mucosa. The risk of adenocarcinoma in the surrounding mucosa is probably higher than in the polyp itself. […] Complete removal of the adenoma should be performed when safe to do so. […] Endoscopic follow-up is required following resection of gastric adenomas. Endoscopy should be repeated at 6 months for incompletely resected polyps or those with high grade dysplasia. Endoscopy can be repeated after 1 year for all other polyps.

• #11 Stomach polyps – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/stomach-polyps/symptoms-causes/syc-20377992

  Stomach polyps are rare and usually don’t cause any signs or symptoms. […] Stomach polyps are most often discovered when your health care provider is examining you for some other reason. […] Most stomach polyps don’t become cancerous. But certain types can increase your risk of stomach cancer. Depending on the type of stomach polyp you have, treatment might involve removing the polyp or monitoring it for changes. […] See your health care provider if you have ongoing blood in your stool or other symptoms of stomach polyps. […] Stomach polyps form in response to damage to your stomach lining. The most common causes of stomach polyps are: Long-lasting stomach inflammation. Also known as gastritis, this condition can cause the formation of hyperplastic polyps and adenomas. […] Adenomas are the least common type of stomach polyp but the type most likely to become cancerous. For that reason, they are generally removed.

• #12 Gastric Polyp – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560704/

  Gastric polyps are found during 6% of EGDs. Sporadic fundic gland polyps represent 37% to 77% of all gastric polyps and are most common in middle-aged women. Hyperplastic polyps are the second most common, reported between 17% and 42% of cases, and gastric adenomas 0.5 % to 1%. Malignancy is found in 1% to 2% of polyploid gastric lesions. […] The prevalence of H pylori has decreased with a concomitant decline in peptic ulcer disease and hyperplastic polyps. Gastroesophageal reflux is the most common pathology noted at endoscopy, with an associated increase in esophageal cancer, cancer of the cardia, and an increase in eosinophilic esophagitis. Gastric adenoma, historically seen more frequently in countries with a high gastric cancer rate, such as China, may be found in up to 10% of gastric polyps in Asian countries and is increasing in Western countries.

• #13 Gastric polyps – UpToDate

  https://www.uptodate.com/contents/gastric-polyps

  Gastric polyps are found in approximately 6 percent of upper gastrointestinal endoscopic procedures in the United States. However, lower rates have been reported in other countries. Hyperplastic polyps and adenomas are relatively more prevalent as compared with fundic gland polyps in regions where Helicobacter pylori infection is common. In contrast, in Western countries, where the prevalence of H. pylori infection is lower and proton pump inhibitor (PPI) use is common, the most commonly encountered polyps are fundic gland polyps. […] This topic will review the epidemiology, clinical manifestations, histopathology, and management of gastric polyps.

• #14 Fundic gland polyp | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/fundic-gland-polyp?lang=us

  Fundic gland polyps occur most commonly in middle-aged females. They have been reported to be identified in ~1% of gastroscopies. […] Fundic gland polyps account for ~60% (range 47-77%) of gastric polyps. […] Fundic gland polyps associated with FAP demonstrate 41% dysplasia and increase the incidence of gastric carcinoma.

• #15 Gastric Polyp – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560704/

  Gastric polyps are found during 6% of EGDs. Sporadic fundic gland polyps represent 37% to 77% of all gastric polyps and are most common in middle-aged women. Hyperplastic polyps are the second most common, reported between 17% and 42% of cases, and gastric adenomas 0.5 % to 1%. Malignancy is found in 1% to 2% of polyploid gastric lesions. […] The prevalence of H pylori has decreased with a concomitant decline in peptic ulcer disease and hyperplastic polyps. Gastroesophageal reflux is the most common pathology noted at endoscopy, with an associated increase in esophageal cancer, cancer of the cardia, and an increase in eosinophilic esophagitis. Gastric adenoma, historically seen more frequently in countries with a high gastric cancer rate, such as China, may be found in up to 10% of gastric polyps in Asian countries and is increasing in Western countries.

• #16 Gastric hyperplastic polyps: a narrative review – Zouridis – Digestive Medicine Research

  https://dmr.amegroups.org/article/view/8601/html

  GHP are frequently encountered during endoscopy and even though initially it was hypothesized that they represent 3093% of all gastric polyps, more recent studies reveal that the exact number is unknown and may be anywhere between 788% (1-3). […] GHP, prior to knowledge and treatment of H. pylori in recent decades, were much more common finding during endoscopy. Since eradication of H. pylori, especially in North America, the incidence of GHP has decreased (13). Studies report GHP are found in 1.28% of endoscopies and make up anywhere from 7% to 88% of gastric polyps identified (2,3). […] Even though GHP are traditionally considered benign lesions, growing evidence suggests malignant potential with some studies describing a malignant transformation risk higher than 8%. Older age, increased size and pedunculated shape are some of the risk factors associated with malignant transformation. Especially GHP larger than 10 mm have greater malignancy risk and should be excised.

• #17 Gastric Polyp – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560704/

  Gastric polyps are found during 6% of EGDs. Sporadic fundic gland polyps represent 37% to 77% of all gastric polyps and are most common in middle-aged women. Hyperplastic polyps are the second most common, reported between 17% and 42% of cases, and gastric adenomas 0.5 % to 1%. Malignancy is found in 1% to 2% of polyploid gastric lesions. […] The prevalence of H pylori has decreased with a concomitant decline in peptic ulcer disease and hyperplastic polyps. Gastroesophageal reflux is the most common pathology noted at endoscopy, with an associated increase in esophageal cancer, cancer of the cardia, and an increase in eosinophilic esophagitis. Gastric adenoma, historically seen more frequently in countries with a high gastric cancer rate, such as China, may be found in up to 10% of gastric polyps in Asian countries and is increasing in Western countries.

• #18 Gastric Polyp – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560704/

  The epidemiology of gastric polyps in individuals with FAP is distinct from the general population. A retrospective review of the distribution of gastric polyps in patients with FAP found 68% fundic gland polyps, 20% hyperplastic polyps, and 15% adenomas, 10% of which contained high-grade dysplasia. High-grade dysplasia was identified in every polyp type, and 2 people with high-grade dysplasia progressed to gastric cancer, but 8 individuals under surveillance for over 5 years did not progress. Fundic gland polyps were found in 88% of those with FAP in a screened population. In one study of this group, results showed that dysplasia was found in 42% of fundic gland polyps. In a pediatric FAP cohort, fundic gland polyps with low-grade dysplasia were identified in 42% of screening endoscopies. Gastric adenomas are found in 10% of those with FAP in the United States and Western Europe and 36% to 50% in Asia. There are case reports of individuals with FAP developing gastric cancer as young as 16 years old, and there has been an overall increase in gastric adenocarcinoma in this population with a reporter incidence of 1.3%.

• #19 Gastric polyps – UpToDate

  https://www.uptodate.com/contents/gastric-polyps

  Gastric polyps are found in approximately 6 percent of upper gastrointestinal endoscopic procedures in the United States. However, lower rates have been reported in other countries. Hyperplastic polyps and adenomas are relatively more prevalent as compared with fundic gland polyps in regions where Helicobacter pylori infection is common. In contrast, in Western countries, where the prevalence of H. pylori infection is lower and proton pump inhibitor (PPI) use is common, the most commonly encountered polyps are fundic gland polyps. […] This topic will review the epidemiology, clinical manifestations, histopathology, and management of gastric polyps.

• #20 Management of gastric polyps | PPT

  https://www.slideshare.net/slideshow/management-of-gastric-polyps/38608402

  Epidemiology Few large epidemiological studies. Incidence: 1-3% of all gastroscopies. M=F. above age of 60 years. Multiple in 25%. Usually asymptomatic, 90% found incidentally. Large polyps can present with bleeding, anaemia or abdominal pain. […] Epidemiology Frequency and type of gastric polyps vary depending on the population and location. H Pylori common PPI less common H Pylori less common PPI common Hyperplastic/ adenoma Fundic Fundic Hyperplastic/ adenoma Fundic glands polyp common in the West. Specific genetic mutations are responsible for polyp formation. […] General principles General management issues are commonly applied to all patients with gastric polyps. Once a polyp is observed, it is removed or biopsied and its pathology identified Prognosis and management are specific to the underlying pathology.

• #21 Gastric polyps – UpToDate

  https://www.uptodate.com/contents/gastric-polyps

  Gastric polyps are found in approximately 6 percent of upper gastrointestinal endoscopic procedures in the United States. However, lower rates have been reported in other countries. Hyperplastic polyps and adenomas are relatively more prevalent as compared with fundic gland polyps in regions where Helicobacter pylori infection is common. In contrast, in Western countries, where the prevalence of H. pylori infection is lower and proton pump inhibitor (PPI) use is common, the most commonly encountered polyps are fundic gland polyps. […] This topic will review the epidemiology, clinical manifestations, histopathology, and management of gastric polyps.

• #22 Gastric polyps: a 10-year analysis of 18,496 upper endoscopies | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-022-02154-8

  Gastric polyps (GPs) are usually asymptomatic lesions of the upper gastrointestinal tract observed in 13% of esophagogastroduodenoscopies (EGD). Most GPs are benign. The aim of this study was to precise the frequency of different types of gastric polyps in our population, and to analyze their possible association with other factors. […] GPs were found in 86 out of 18,496 (0.46%) reviewed EGD, corresponding to a total of 141 polyps. […] The most common location was the fundus (59.6%) and 48.9% were smaller than 5 mm. […] According to Paris classification, 80% of the polyps were sessile (Is). Hyperplastic polyps were the most common (55.9%), followed by sporadic fundic gland polyps observed in 23 patients (18.1%), 7 (5.5%) were adenomas and 4 (3.1%) were neuroendocrine tumors type 1. […] The following factors were associated with hyperplastic polyps: anemia (p=0.022), single polyp (p=0.025) and size5 mm (p=0.048).

• #23

  https://www.termedia.pl/Gastric-polyps-a-retrospective-cohort-analysis-r-nof-23-668-endoscopies-indicates-changing-r-nepidemiological-and-phenotypic-characteristics,41,52630,1,1.html

  Taking into consideration the total amount of endoscopies included in the study, the fact that biopsies from endoscopically detected polypoid lesions were performed in 3 out of 4 patients, and that histology revealed an epithelial gastric polyp in 55.4% of biopsies, the prevalence of epithelial polyps in our population during the study period was 1.7%. […] When comparing the epidemiological data reported above between the 2 periods of time (period A and B), no difference was detected in patients demographics age and sex. […] Specifically, the number of polyps per patient increased and the location of polyps gradually shifted from antrum to fundus and corpus, both of which are a consequence of the rise of FGPs, which tend to be numerous and located in the upper part of the stomach. […] Our study included a large number of endoscopies with a considerable number of polypoid lesions, and thus consistently portrays the current pattern of epithelial gastric polyps as well as the timeline of their change during the last 15 years.

• #24 How to manage gastric polyps

  https://www.ijgii.org/journal/view.html?doi=10.18528/gii150035

  Gastric cancer is the second leading cause of cancer related death in the world. In United States, gastric polyps are found in approximately 6% of upper endoscopy. The incidence of gastric polyps increased with widespread use of esophagogastroduodenoscopy and more liberal use of proton pump inhibitors. […] Endoscopy plays key role not only in diagnosis but also in surveillance. With narrow band imaging and chromo endoscopy, we are much better today in detecting and discerning these. […] Surveillance with esophagogastroduodenoscopy (EGD) is not recommended in sporadic FGP as gastric cancer is rare, but in FAP, it is recommended because 30% to 50% of them may be associated with low grade dysplasia. […] Endoscopic follow-up for gastric adenoma should be done 6 months after incomplete polypectomy or for high grade dysplasia and 1 year for all other polyps. […] Endoscopic surveillance should be considered for stage 3 or stage 4 OLGA but the guidelines are not standardized.

• #25 Gastric Polyps Detected Incidentally during Gastroscopy and Follow-Up Results

  https://www.mdpi.com/2077-0383/13/11/3117

  The epidemiology of gastritis, gastric atrophy, and gastric lesions associated with increased acid imbalance has undergone significant changes, and the frequency of polyps is thought to be increasing. […] Over 90% of polyps are asymptomatic and may be found incidentally. […] Although typical appearances of some types of polyps can be seen using endoscopy, a histological evaluation is required to determine the presence of dysplasia. Therefore, a polypectomy should be performed for all gastric polyps to assess the pre-malignancy risk. […] The relationship between stomach polyps and colon cancer is an important one due to its frequency. A study conducted in 2013 showed that the presence of concurrent colonic neoplasias increased in patients with gastric adenoma or cancer, and a pre-treatment screening colonoscopy is recommended.

• #26 Fundic gland polyps: Should my patient stop taking PPIs? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/90/3/157

  Fundic gland polyps (FGPs) associated with proton pump inhibitors (PPIs) are generally considered benign, and patients without high-risk features (ie, more than 20 FGPs or polyp size greater than 1 cm) can be advised to continue taking the PPI if there is a clear indication for its use. […] Long-term PPI use can promote development of FGPs in the stomach because the decrease in stomach acidity leads to increased production of gastrin. […] The number and size of FGPs is proportionate to the dose and duration of PPI therapy. […] PPI-associated FGPs have not been linked to an increased risk of malignant transformation compared with the risk in the general population. […] The incidence of sporadic FGPs appears to be inversely correlated with Helicobacter pylori infection. […] There are no guidelines regarding follow-up of sporadic FGPs.

• #27 Gastric Polyp – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560704/

  The epidemiology of gastric polyps in individuals with FAP is distinct from the general population. A retrospective review of the distribution of gastric polyps in patients with FAP found 68% fundic gland polyps, 20% hyperplastic polyps, and 15% adenomas, 10% of which contained high-grade dysplasia. High-grade dysplasia was identified in every polyp type, and 2 people with high-grade dysplasia progressed to gastric cancer, but 8 individuals under surveillance for over 5 years did not progress. Fundic gland polyps were found in 88% of those with FAP in a screened population. In one study of this group, results showed that dysplasia was found in 42% of fundic gland polyps. In a pediatric FAP cohort, fundic gland polyps with low-grade dysplasia were identified in 42% of screening endoscopies. Gastric adenomas are found in 10% of those with FAP in the United States and Western Europe and 36% to 50% in Asia. There are case reports of individuals with FAP developing gastric cancer as young as 16 years old, and there has been an overall increase in gastric adenocarcinoma in this population with a reporter incidence of 1.3%.

• #28 Gastric hyperplastic polyps: a narrative review – Zouridis – Digestive Medicine Research

  https://dmr.amegroups.org/article/view/8601/html

  GHP are frequently encountered during endoscopy and even though initially it was hypothesized that they represent 3093% of all gastric polyps, more recent studies reveal that the exact number is unknown and may be anywhere between 788% (1-3). […] GHP, prior to knowledge and treatment of H. pylori in recent decades, were much more common finding during endoscopy. Since eradication of H. pylori, especially in North America, the incidence of GHP has decreased (13). Studies report GHP are found in 1.28% of endoscopies and make up anywhere from 7% to 88% of gastric polyps identified (2,3). […] Even though GHP are traditionally considered benign lesions, growing evidence suggests malignant potential with some studies describing a malignant transformation risk higher than 8%. Older age, increased size and pedunculated shape are some of the risk factors associated with malignant transformation. Especially GHP larger than 10 mm have greater malignancy risk and should be excised.

• #29

  https://www.termedia.pl/Gastric-polyps-a-retrospective-cohort-analysis-r-nof-23-668-endoscopies-indicates-changing-r-nepidemiological-and-phenotypic-characteristics,41,52630,1,1.html

  Taking into consideration the total amount of endoscopies included in the study, the fact that biopsies from endoscopically detected polypoid lesions were performed in 3 out of 4 patients, and that histology revealed an epithelial gastric polyp in 55.4% of biopsies, the prevalence of epithelial polyps in our population during the study period was 1.7%. […] When comparing the epidemiological data reported above between the 2 periods of time (period A and B), no difference was detected in patients demographics age and sex. […] Specifically, the number of polyps per patient increased and the location of polyps gradually shifted from antrum to fundus and corpus, both of which are a consequence of the rise of FGPs, which tend to be numerous and located in the upper part of the stomach. […] Our study included a large number of endoscopies with a considerable number of polypoid lesions, and thus consistently portrays the current pattern of epithelial gastric polyps as well as the timeline of their change during the last 15 years.

• #30 Gastric Polyps: A Review of Clinical, Endoscopic, and Histopathologic Features and Management Decisions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3992058/

  The increasing use of endoscopy has led to more discernable abnormalities in the stomach, including polyps. […] Despite their high prevalence, there is a paucity of literature to support management and treatment decisions for endoscopists. […] Gastric polyps most frequently originate in the mucosa but encompass a broad spectrum of pathologic conditions that may even be submucosal or extrinsic. […] Found in 6% of upper endoscopies, gastric polyps are a heterogeneous group of epithelial and subepithelial lesions that can vary in histology, neoplastic potential, and management. […] Most have no risk of cancer, but there are certain subsets of polyps with malignant potential, necessitating further endoscopic treatment and/or periodic surveillance. […] The recommendations for initial management and follow-up should be followed at the discretion of the endoscopist.

• #31 Gastric Polyp – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560704/

  The epidemiology of gastric polyps in individuals with FAP is distinct from the general population. A retrospective review of the distribution of gastric polyps in patients with FAP found 68% fundic gland polyps, 20% hyperplastic polyps, and 15% adenomas, 10% of which contained high-grade dysplasia. High-grade dysplasia was identified in every polyp type, and 2 people with high-grade dysplasia progressed to gastric cancer, but 8 individuals under surveillance for over 5 years did not progress. Fundic gland polyps were found in 88% of those with FAP in a screened population. In one study of this group, results showed that dysplasia was found in 42% of fundic gland polyps. In a pediatric FAP cohort, fundic gland polyps with low-grade dysplasia were identified in 42% of screening endoscopies. Gastric adenomas are found in 10% of those with FAP in the United States and Western Europe and 36% to 50% in Asia. There are case reports of individuals with FAP developing gastric cancer as young as 16 years old, and there has been an overall increase in gastric adenocarcinoma in this population with a reporter incidence of 1.3%.

• #32 Gastric Polyp – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560704/

  The epidemiology of gastric polyps in individuals with FAP is distinct from the general population. A retrospective review of the distribution of gastric polyps in patients with FAP found 68% fundic gland polyps, 20% hyperplastic polyps, and 15% adenomas, 10% of which contained high-grade dysplasia. High-grade dysplasia was identified in every polyp type, and 2 people with high-grade dysplasia progressed to gastric cancer, but 8 individuals under surveillance for over 5 years did not progress. Fundic gland polyps were found in 88% of those with FAP in a screened population. In one study of this group, results showed that dysplasia was found in 42% of fundic gland polyps. In a pediatric FAP cohort, fundic gland polyps with low-grade dysplasia were identified in 42% of screening endoscopies. Gastric adenomas are found in 10% of those with FAP in the United States and Western Europe and 36% to 50% in Asia. There are case reports of individuals with FAP developing gastric cancer as young as 16 years old, and there has been an overall increase in gastric adenocarcinoma in this population with a reporter incidence of 1.3%.

• #33 Gastric Polyp – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560704/

  The epidemiology of gastric polyps in individuals with FAP is distinct from the general population. A retrospective review of the distribution of gastric polyps in patients with FAP found 68% fundic gland polyps, 20% hyperplastic polyps, and 15% adenomas, 10% of which contained high-grade dysplasia. High-grade dysplasia was identified in every polyp type, and 2 people with high-grade dysplasia progressed to gastric cancer, but 8 individuals under surveillance for over 5 years did not progress. Fundic gland polyps were found in 88% of those with FAP in a screened population. In one study of this group, results showed that dysplasia was found in 42% of fundic gland polyps. In a pediatric FAP cohort, fundic gland polyps with low-grade dysplasia were identified in 42% of screening endoscopies. Gastric adenomas are found in 10% of those with FAP in the United States and Western Europe and 36% to 50% in Asia. There are case reports of individuals with FAP developing gastric cancer as young as 16 years old, and there has been an overall increase in gastric adenocarcinoma in this population with a reporter incidence of 1.3%.

• #34 Gastric Polyp – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560704/

  The epidemiology of gastric polyps in individuals with FAP is distinct from the general population. A retrospective review of the distribution of gastric polyps in patients with FAP found 68% fundic gland polyps, 20% hyperplastic polyps, and 15% adenomas, 10% of which contained high-grade dysplasia. High-grade dysplasia was identified in every polyp type, and 2 people with high-grade dysplasia progressed to gastric cancer, but 8 individuals under surveillance for over 5 years did not progress. Fundic gland polyps were found in 88% of those with FAP in a screened population. In one study of this group, results showed that dysplasia was found in 42% of fundic gland polyps. In a pediatric FAP cohort, fundic gland polyps with low-grade dysplasia were identified in 42% of screening endoscopies. Gastric adenomas are found in 10% of those with FAP in the United States and Western Europe and 36% to 50% in Asia. There are case reports of individuals with FAP developing gastric cancer as young as 16 years old, and there has been an overall increase in gastric adenocarcinoma in this population with a reporter incidence of 1.3%.

• #35 Gastric Polyp – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560704/

  The epidemiology of gastric polyps in individuals with FAP is distinct from the general population. A retrospective review of the distribution of gastric polyps in patients with FAP found 68% fundic gland polyps, 20% hyperplastic polyps, and 15% adenomas, 10% of which contained high-grade dysplasia. High-grade dysplasia was identified in every polyp type, and 2 people with high-grade dysplasia progressed to gastric cancer, but 8 individuals under surveillance for over 5 years did not progress. Fundic gland polyps were found in 88% of those with FAP in a screened population. In one study of this group, results showed that dysplasia was found in 42% of fundic gland polyps. In a pediatric FAP cohort, fundic gland polyps with low-grade dysplasia were identified in 42% of screening endoscopies. Gastric adenomas are found in 10% of those with FAP in the United States and Western Europe and 36% to 50% in Asia. There are case reports of individuals with FAP developing gastric cancer as young as 16 years old, and there has been an overall increase in gastric adenocarcinoma in this population with a reporter incidence of 1.3%.

• #36 Gastric Polyp – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560704/

  The epidemiology of gastric polyps in individuals with FAP is distinct from the general population. A retrospective review of the distribution of gastric polyps in patients with FAP found 68% fundic gland polyps, 20% hyperplastic polyps, and 15% adenomas, 10% of which contained high-grade dysplasia. High-grade dysplasia was identified in every polyp type, and 2 people with high-grade dysplasia progressed to gastric cancer, but 8 individuals under surveillance for over 5 years did not progress. Fundic gland polyps were found in 88% of those with FAP in a screened population. In one study of this group, results showed that dysplasia was found in 42% of fundic gland polyps. In a pediatric FAP cohort, fundic gland polyps with low-grade dysplasia were identified in 42% of screening endoscopies. Gastric adenomas are found in 10% of those with FAP in the United States and Western Europe and 36% to 50% in Asia. There are case reports of individuals with FAP developing gastric cancer as young as 16 years old, and there has been an overall increase in gastric adenocarcinoma in this population with a reporter incidence of 1.3%.

• #37 Gastric Polyp – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560704/

  The epidemiology of gastric polyps in individuals with FAP is distinct from the general population. A retrospective review of the distribution of gastric polyps in patients with FAP found 68% fundic gland polyps, 20% hyperplastic polyps, and 15% adenomas, 10% of which contained high-grade dysplasia. High-grade dysplasia was identified in every polyp type, and 2 people with high-grade dysplasia progressed to gastric cancer, but 8 individuals under surveillance for over 5 years did not progress. Fundic gland polyps were found in 88% of those with FAP in a screened population. In one study of this group, results showed that dysplasia was found in 42% of fundic gland polyps. In a pediatric FAP cohort, fundic gland polyps with low-grade dysplasia were identified in 42% of screening endoscopies. Gastric adenomas are found in 10% of those with FAP in the United States and Western Europe and 36% to 50% in Asia. There are case reports of individuals with FAP developing gastric cancer as young as 16 years old, and there has been an overall increase in gastric adenocarcinoma in this population with a reporter incidence of 1.3%.

• #38 Incidence of gastric cancers and associated risk factors in patients with familial adenomatous polyposis – Mayo Clinic

  https://www.mayoclinic.org/medical-professionals/digestive-diseases/news/incidence-of-gastric-cancers-and-associated-risk-factors-in-patients-with-familial-adenomatous-polyposis/mac-20577242

  Familial adenomatous polyposis increases an individual’s risk of colorectal cancer and other conditions, including gastric polyposis, which is depicted in these images. […] Although gastric polyposis commonly occurs in people with FAP, there is a lack of consensus about the incidence of gastric cancer in these patients. Additionally, there are no universally accepted guidelines outlining how and when to conduct screening and surveillance and which risk factors, if any, warrant prophylactic total gastrectomy to reduce the risk of progression to gastric cancer. […] „Our study found that the overall risk of stomach cancer in FAP is low and that despite extensive polyposis of the stomach, endoscopic surveillance and sampling can identify the few patients at risk for subsequent development of stomach cancer,” explains Dr. Grotz.

• #39 Incidence of gastric cancers and associated risk factors in patients with familial adenomatous polyposis – Mayo Clinic

  https://www.mayoclinic.org/medical-professionals/digestive-diseases/news/incidence-of-gastric-cancers-and-associated-risk-factors-in-patients-with-familial-adenomatous-polyposis/mac-20577242

  „We are hopeful that these findings will encourage the development of gastric cancer surveillance guidelines specific to patients with FAP that could help improve detection rates, guide timely intervention, and ultimately improve survival rates and quality of life in this high-risk patient population,” explains Lisa A. Boardman, M.D., a gastroenterologist and researcher at Mayo Clinic in Rochester, Minnesota, and a co-author on the study publication. […] Dr. Grotz adds that implementing these endoscopic surveillance strategies and expanding this analysis to other secondary cancers such as pancreatic and duodenal cancers would be appropriate next steps.

• #40 Management of gastric polyps | PPT

  https://www.slideshare.net/slideshow/management-of-gastric-polyps/38608402

  All gastric polyps should be biopsied and examined microscopically for histologic characterization due to risk of cancer. Forceps biopsy alone cannot exclude foci of HGD or early gastric cancer in large (1 cm) polyps. Polypectomy is generally indicated for all neoplastic polyps and other polyps 1 cm in diameter. […] H.Pylori infection All patients with hyperplastic gastric polyps should be tested for H. pylori, if positive, treated with eradication therapy. Treatment has been associated with regression of polyps in some patients. […] Repeat gastroscopy should be performed at 1 year for all polyps with dysplasia that have not been removed. Repeat gastroscopy should be performed at 1 year following complete polypectomy for high risk polyp. […] Management of gastric polyps associated with polyposis Syndrome Life time risk of malignancy Surveillance recommendation FAP 100% (colon) OGD every 2 years after 18 Biopsy 5 polyps Remove polyps 1 cm Peutz-Jeghers 50% (extra-GI) OGD every 2 years after 18 Biopsy 5 polyps Remove polyp 1 cm Juvenile polyp 50% OGD every 3 years after 18 Cowdens Rare Eradicate H pylori No further OGD needed.

• #41 Diagnosis and management of cancer risk for gastrointestinal hamartomatous polyposis syndromes – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/diagnosis-and-management-of-cancer-risk-for-gastrointestinal-hamartomatous-polyposis-syndromes/

  The task force recommends that baseline small bowel surveillance using video capsule endoscopy or magnetic resonance enterography be performed between ages 8-10 years or earlier if the patient is symptomatic. […] The task force recommends polypectomy of small bowel polyps that are symptomatic or ≥10 mm to prevent intussusception and other complications, such as bleeding. […] Juvenile polyposis syndrome patients are at increased risk for cancer in multiple organs including cancer of the colon and stomach. Given this risk, the task force recommends patients with juvenile polyposis syndrome undergo surveillance of the colon and stomach. […] The task force suggests initiating colonoscopic and upper endoscopic surveillance at age 12-15 years, or earlier if symptomatic. Surveillance should be repeated every 1-3 years depending on polyp burden.

• #42 Management of gastric polyps | PPT

  https://www.slideshare.net/slideshow/management-of-gastric-polyps/38608402

  All gastric polyps should be biopsied and examined microscopically for histologic characterization due to risk of cancer. Forceps biopsy alone cannot exclude foci of HGD or early gastric cancer in large (1 cm) polyps. Polypectomy is generally indicated for all neoplastic polyps and other polyps 1 cm in diameter. […] H.Pylori infection All patients with hyperplastic gastric polyps should be tested for H. pylori, if positive, treated with eradication therapy. Treatment has been associated with regression of polyps in some patients. […] Repeat gastroscopy should be performed at 1 year for all polyps with dysplasia that have not been removed. Repeat gastroscopy should be performed at 1 year following complete polypectomy for high risk polyp. […] Management of gastric polyps associated with polyposis Syndrome Life time risk of malignancy Surveillance recommendation FAP 100% (colon) OGD every 2 years after 18 Biopsy 5 polyps Remove polyps 1 cm Peutz-Jeghers 50% (extra-GI) OGD every 2 years after 18 Biopsy 5 polyps Remove polyp 1 cm Juvenile polyp 50% OGD every 3 years after 18 Cowdens Rare Eradicate H pylori No further OGD needed.

• #43 Differential Diagnoses and Management Approaches for Gastric Polyposis

  https://www.mdpi.com/2036-7422/15/1/9

  Patients with a family history of desmoid tumors should undergo abdominal and pelvic computed tomography (CT) or magnetic resonance imaging every three years after a colectomy to confirm the presence or absence of desmoids. […] In light of the potential for childhood intussusception necessitating surgical intervention, patients are advised to undergo baseline gastrointestinal tract surveillance between the ages of 8 and 10 years or sooner if they manifest symptoms. […] The commencement of annual pancreatic cancer surveillance is recommended at the age of 30–35 years by employing magnetic resonance cholangiopancreatography or endoscopic ultrasound. […] Therefore, a multidisciplinary approach to cancer surveillance in these organs is essential. […] Gastric polyps are typically several millimeters to 20 mm in size and are often observed diffusely as sessile or slightly pedunculated elevations with a dense distribution.

• #44 Management of gastric polyps | PPT

  https://www.slideshare.net/slideshow/management-of-gastric-polyps/38608402

  All gastric polyps should be biopsied and examined microscopically for histologic characterization due to risk of cancer. Forceps biopsy alone cannot exclude foci of HGD or early gastric cancer in large (1 cm) polyps. Polypectomy is generally indicated for all neoplastic polyps and other polyps 1 cm in diameter. […] H.Pylori infection All patients with hyperplastic gastric polyps should be tested for H. pylori, if positive, treated with eradication therapy. Treatment has been associated with regression of polyps in some patients. […] Repeat gastroscopy should be performed at 1 year for all polyps with dysplasia that have not been removed. Repeat gastroscopy should be performed at 1 year following complete polypectomy for high risk polyp. […] Management of gastric polyps associated with polyposis Syndrome Life time risk of malignancy Surveillance recommendation FAP 100% (colon) OGD every 2 years after 18 Biopsy 5 polyps Remove polyps 1 cm Peutz-Jeghers 50% (extra-GI) OGD every 2 years after 18 Biopsy 5 polyps Remove polyp 1 cm Juvenile polyp 50% OGD every 3 years after 18 Cowdens Rare Eradicate H pylori No further OGD needed.

• #45 Researchers Uncover Concerning Rise in Gastric Cancer, Despite Careful Monitoring, in FAP Patients

  https://consultqd.clevelandclinic.org/researchers-uncover-concerning-rise-in-gastric-cancer-despite-careful-monitoring-in-fap-patients

  Today, at risk, FAP patients undergo genetic testing to see if they have inherited the mutation that causes FAP and have their colons checked for polyps and removed before CRC develops. […] This caused us to question the approach to surveillance and treatment of stomach polyps and to formulate new recommendations for monitoring FAP patients. […] Our FAP patients were getting their routine endoscopy surveillance (EGD) but developing advanced, and the majority of the time, metastatic, untreatable and fatal gastric cancer, Dr. Bhatt says, so endoscopic surveillance was failing them. […] The group changed their approach to surveillance of FAP patients with high risk gastric features (carpeting and mounds) in an effort to prevent or detect early cancer. […] Since we changed our approach of our high risk gastric polyposis FAP patients, we have detected gastric cancer at an early stage, Dr. Burke says.

• #46 Researchers Uncover Concerning Rise in Gastric Cancer, Despite Careful Monitoring, in FAP Patients

  https://consultqd.clevelandclinic.org/researchers-uncover-concerning-rise-in-gastric-cancer-despite-careful-monitoring-in-fap-patients

  Today, at risk, FAP patients undergo genetic testing to see if they have inherited the mutation that causes FAP and have their colons checked for polyps and removed before CRC develops. […] This caused us to question the approach to surveillance and treatment of stomach polyps and to formulate new recommendations for monitoring FAP patients. […] Our FAP patients were getting their routine endoscopy surveillance (EGD) but developing advanced, and the majority of the time, metastatic, untreatable and fatal gastric cancer, Dr. Bhatt says, so endoscopic surveillance was failing them. […] The group changed their approach to surveillance of FAP patients with high risk gastric features (carpeting and mounds) in an effort to prevent or detect early cancer. […] Since we changed our approach of our high risk gastric polyposis FAP patients, we have detected gastric cancer at an early stage, Dr. Burke says.

• #47 Gastric Polyps: A Review of Clinical, Endoscopic, and Histopathologic Features and Management Decisions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3992058/

  Current guidelines do not require polypectomy for sporadic FGP due to its low malignancy potential. […] However, despite the characteristic endoscopic appearance of FGP, biopsy is recommended at the initial endoscopy to exclude dysplasia or adenocarcinoma as well as the need for further polypectomy if other types of polyps are present. […] Surveillance endoscopy is not recommended for patients with nondysplastic sporadic FGPs. […] Gastric hyperplastic polyps are strongly associated with inflammatory disorders such as chronic gastritis, H pylori gastritis, pernicious anemia, and reactive or chemical gastritis. […] The lack of consensus stems from the concern that forceps biopsy sampling may miss the dysplastic foci within a hyperplastic polyp. […] Current recommendations require multiple biopsies of the fat uninvolved mucosa surrounding the polyp.

• #48 Gastric Polyps: A Review of Clinical, Endoscopic, and Histopathologic Features and Management Decisions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3992058/

  Current guidelines do not require polypectomy for sporadic FGP due to its low malignancy potential. […] However, despite the characteristic endoscopic appearance of FGP, biopsy is recommended at the initial endoscopy to exclude dysplasia or adenocarcinoma as well as the need for further polypectomy if other types of polyps are present. […] Surveillance endoscopy is not recommended for patients with nondysplastic sporadic FGPs. […] Gastric hyperplastic polyps are strongly associated with inflammatory disorders such as chronic gastritis, H pylori gastritis, pernicious anemia, and reactive or chemical gastritis. […] The lack of consensus stems from the concern that forceps biopsy sampling may miss the dysplastic foci within a hyperplastic polyp. […] Current recommendations require multiple biopsies of the fat uninvolved mucosa surrounding the polyp.

• #49 How to manage gastric polyps

  https://www.ijgii.org/journal/view.html?doi=10.18528/gii150035

  Gastric cancer is the second leading cause of cancer related death in the world. In United States, gastric polyps are found in approximately 6% of upper endoscopy. The incidence of gastric polyps increased with widespread use of esophagogastroduodenoscopy and more liberal use of proton pump inhibitors. […] Endoscopy plays key role not only in diagnosis but also in surveillance. With narrow band imaging and chromo endoscopy, we are much better today in detecting and discerning these. […] Surveillance with esophagogastroduodenoscopy (EGD) is not recommended in sporadic FGP as gastric cancer is rare, but in FAP, it is recommended because 30% to 50% of them may be associated with low grade dysplasia. […] Endoscopic follow-up for gastric adenoma should be done 6 months after incomplete polypectomy or for high grade dysplasia and 1 year for all other polyps. […] Endoscopic surveillance should be considered for stage 3 or stage 4 OLGA but the guidelines are not standardized.

• #50 Fundic gland polyps: Should my patient stop taking PPIs? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/90/3/157

  In general, for patients with sporadic FGPs in whom syndromic FGPs are ruled out, PPI therapy can be continued at the lowest effective dose for as long as indicated. […] However, PPI cessation should be considered if there are more than 20 polyps or polyps larger than 1 cm, especially if there are so many polyps as to give a carpeting appearance. […] Several studies suggest that if dysplasia is found in sporadic FGPs, progression to gastric cancer occurs slowly, if at all, and repeat endoscopy 1 to 3 years after polypectomy is reasonable. […] Evidence demonstrates regression of FGPs if PPIs are stopped, even if they were large in size, and endoscopic follow-up to confirm regression is unnecessary. […] If syndromic FGPs are ruled out and the patient is taking a PPI, we recommend considering PPI cessation if there are 20 or more FGPs or polyp size is larger than 1 cm. […] With increasing use of PPIs and increasing incidence of PPI-associated FGPs, updated evidence is needed to elucidate the natural history of these polyps and identify risk factors for malignant transformation.

• #51 How to manage gastric polyps

  https://www.ijgii.org/journal/view.html?doi=10.18528/gii150035

  Gastric cancer is the second leading cause of cancer related death in the world. In United States, gastric polyps are found in approximately 6% of upper endoscopy. The incidence of gastric polyps increased with widespread use of esophagogastroduodenoscopy and more liberal use of proton pump inhibitors. […] Endoscopy plays key role not only in diagnosis but also in surveillance. With narrow band imaging and chromo endoscopy, we are much better today in detecting and discerning these. […] Surveillance with esophagogastroduodenoscopy (EGD) is not recommended in sporadic FGP as gastric cancer is rare, but in FAP, it is recommended because 30% to 50% of them may be associated with low grade dysplasia. […] Endoscopic follow-up for gastric adenoma should be done 6 months after incomplete polypectomy or for high grade dysplasia and 1 year for all other polyps. […] Endoscopic surveillance should be considered for stage 3 or stage 4 OLGA but the guidelines are not standardized.

• #52 Management of gastric polyps | PPT

  https://www.slideshare.net/slideshow/management-of-gastric-polyps/38608402

  All gastric polyps should be biopsied and examined microscopically for histologic characterization due to risk of cancer. Forceps biopsy alone cannot exclude foci of HGD or early gastric cancer in large (1 cm) polyps. Polypectomy is generally indicated for all neoplastic polyps and other polyps 1 cm in diameter. […] H.Pylori infection All patients with hyperplastic gastric polyps should be tested for H. pylori, if positive, treated with eradication therapy. Treatment has been associated with regression of polyps in some patients. […] Repeat gastroscopy should be performed at 1 year for all polyps with dysplasia that have not been removed. Repeat gastroscopy should be performed at 1 year following complete polypectomy for high risk polyp. […] Management of gastric polyps associated with polyposis Syndrome Life time risk of malignancy Surveillance recommendation FAP 100% (colon) OGD every 2 years after 18 Biopsy 5 polyps Remove polyps 1 cm Peutz-Jeghers 50% (extra-GI) OGD every 2 years after 18 Biopsy 5 polyps Remove polyp 1 cm Juvenile polyp 50% OGD every 3 years after 18 Cowdens Rare Eradicate H pylori No further OGD needed.

• #53 Gastric polyps: a 10-year analysis of 18,496 upper endoscopies | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-022-02154-8

  In our study, the GPs frequency was 0.36%. Hyperplastic polyps and fundic gland are the most common in our country. […] Gastric polyps are usually discovered incidentally during esophagogastroduodenoscopies (EGD) and their prevalence is estimated from 0.5 to 23% of all upper gastrointestinal endoscopies. […] The majority of polyps are benign (85% of cases). The risk of malignancy or malignant transformation of gastric polyps depends on their histological nature. […] Hyperplastic polyps are associated with chronic gastritis such as H. pylori gastritis, and particularly autoimmune gastritis. […] In our study, adenomas were detected in seven patients (5.5%). […] Hyperplastic polyps should be biopsied according to the British society of gastroenterology and an examination of the whole stomach should be made. H pylori infection should be detected and eradicated when present. […] Guidelines on management of hyperplastic polyps, recommend resection of polyps greater than 5 mm. […] Polypectomy is not required for sporadic fundic gland polyps.

• #54 Gastric hyperplastic polyps: a narrative review – Zouridis – Digestive Medicine Research

  https://dmr.amegroups.org/article/view/8601/html

  The risk for malignant transformation has been evaluated in detail with estimations mainly between 0.66.6% while a few studies suggest higher rates, up to 8.6% (11,42-44). […] The exact mechanism of malignant transformation has yet to be understood but multiple studies evaluating the underlying histopathology and immunochemistry tried to reveal possible underlying pathogenetic mechanisms of hyperplasia to carcinoma sequence. […] Irrespective of the underlying mechanism, multiple risk factors have been associated with neoplasia development in GHP. Older age, number of GHP detected, size, lobulation, pedunculated shape are proven to have positive correlation with dysplasia/neoplasia presence within GHP (12,19,40). H. pylori infection is also associated with increased risk for dysplasia/ neoplasia development within GHP, while eradication of the organism may even prevent malignant transformation (19). […] Due to that risk, current evidence suggest removal of GHP especially if 1 cm.

• #55 Gastric polyps: a 10-year analysis of 18,496 upper endoscopies | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-022-02154-8

  In our study, the GPs frequency was 0.36%. Hyperplastic polyps and fundic gland are the most common in our country. […] Gastric polyps are usually discovered incidentally during esophagogastroduodenoscopies (EGD) and their prevalence is estimated from 0.5 to 23% of all upper gastrointestinal endoscopies. […] The majority of polyps are benign (85% of cases). The risk of malignancy or malignant transformation of gastric polyps depends on their histological nature. […] Hyperplastic polyps are associated with chronic gastritis such as H. pylori gastritis, and particularly autoimmune gastritis. […] In our study, adenomas were detected in seven patients (5.5%). […] Hyperplastic polyps should be biopsied according to the British society of gastroenterology and an examination of the whole stomach should be made. H pylori infection should be detected and eradicated when present. […] Guidelines on management of hyperplastic polyps, recommend resection of polyps greater than 5 mm. […] Polypectomy is not required for sporadic fundic gland polyps.

• #56 Management of gastric polyps | PPT

  https://www.slideshare.net/slideshow/management-of-gastric-polyps/38608402

  All gastric polyps should be biopsied and examined microscopically for histologic characterization due to risk of cancer. Forceps biopsy alone cannot exclude foci of HGD or early gastric cancer in large (1 cm) polyps. Polypectomy is generally indicated for all neoplastic polyps and other polyps 1 cm in diameter. […] H.Pylori infection All patients with hyperplastic gastric polyps should be tested for H. pylori, if positive, treated with eradication therapy. Treatment has been associated with regression of polyps in some patients. […] Repeat gastroscopy should be performed at 1 year for all polyps with dysplasia that have not been removed. Repeat gastroscopy should be performed at 1 year following complete polypectomy for high risk polyp. […] Management of gastric polyps associated with polyposis Syndrome Life time risk of malignancy Surveillance recommendation FAP 100% (colon) OGD every 2 years after 18 Biopsy 5 polyps Remove polyps 1 cm Peutz-Jeghers 50% (extra-GI) OGD every 2 years after 18 Biopsy 5 polyps Remove polyp 1 cm Juvenile polyp 50% OGD every 3 years after 18 Cowdens Rare Eradicate H pylori No further OGD needed.

• #57 How to Manage Gastric Polyps Discovered on Endoscopy

  https://www.medscape.com/viewarticle/706939

  The discovery of gastric polyps during an endoscopic examination of the stomach is a relatively common occurrence for gastroenterologists. […] Although no guidance is offered regarding optimal intervals for follow-up examinations, regular surveillance by endoscopy is recommended. […] The overall prevalence of dysplasia is estimated at less than 2%; however, the risk is higher if polyps exceed 2 cm in size. […] For this reason, large polyps must be completely excised. […] Endoscopic resection is appropriate, and surveillance follow-up at 1 year is recommended. […] There is no defined guideline for the care of patients who have familial polyposis, but it is suggested that endoscopic surveillance be performed at 30 years of age and at 3-year intervals. […] For patients who have this syndrome, endoscopic surveillance should begin at 18 years of age and continue at 2- to 3-year intervals.

• #58 Gastric Polyps: A Review of Clinical, Endoscopic, and Histopathologic Features and Management Decisions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3992058/

  Due to the increased risk of malignancy associated with these polyps, recommendations include complete removal of the adenoma, with further examination of the entire gastric mucosa for abnormalities, all of which should be biopsied. […] Endoscopic follow-up is required after resection at 6 months (for incompletely resected polyps or high-grade dysplasia) or 1 year (for all other polyps). […] Gastric polyps are a common finding during routine endoscopy. […] Despite the fact that more than 90% are asymptomatic and do not have malignant potential, a subset of gastric polyps require further intervention, and histologic evaluation is necessary to determine the type of polyp and the presence of dysplasia.

• #59 Gastroenterology Education and CPD for trainees and specialists » Gastric polyps

  https://www.gastrotraining.com/gastric-polyps

  Gastric polyps are mostly asymptomatic (90%) and are typically found incidentally at OGD. Larger polyps can present with bleeding, anemia, abdominal pain or gastric outlet obstruction. […] Majority of gastric polyps are hyperplastic in nature (30-93%). […] Hyperplastic polyps should be biopsied and an examination of the whole stomach should be made for mucosal abnormalities and any abnormalities biopsied. Hyperplastic polyps rarely undergo neoplastic transformation; however there is an increased risk of neoplasia in the surrounding abnormal gastric mucosa. The risk of adenocarcinoma in the surrounding mucosa is probably higher than in the polyp itself. […] Complete removal of the adenoma should be performed when safe to do so. […] Endoscopic follow-up is required following resection of gastric adenomas. Endoscopy should be repeated at 6 months for incompletely resected polyps or those with high grade dysplasia. Endoscopy can be repeated after 1 year for all other polyps.

• #60 Gastric Polyps: A Review of Clinical, Endoscopic, and Histopathologic Features and Management Decisions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3992058/

  Due to the increased risk of malignancy associated with these polyps, recommendations include complete removal of the adenoma, with further examination of the entire gastric mucosa for abnormalities, all of which should be biopsied. […] Endoscopic follow-up is required after resection at 6 months (for incompletely resected polyps or high-grade dysplasia) or 1 year (for all other polyps). […] Gastric polyps are a common finding during routine endoscopy. […] Despite the fact that more than 90% are asymptomatic and do not have malignant potential, a subset of gastric polyps require further intervention, and histologic evaluation is necessary to determine the type of polyp and the presence of dysplasia.

• #61 How to manage gastric polyps

  https://www.ijgii.org/journal/view.html?doi=10.18528/gii150035

  Gastric cancer is the second leading cause of cancer related death in the world. In United States, gastric polyps are found in approximately 6% of upper endoscopy. The incidence of gastric polyps increased with widespread use of esophagogastroduodenoscopy and more liberal use of proton pump inhibitors. […] Endoscopy plays key role not only in diagnosis but also in surveillance. With narrow band imaging and chromo endoscopy, we are much better today in detecting and discerning these. […] Surveillance with esophagogastroduodenoscopy (EGD) is not recommended in sporadic FGP as gastric cancer is rare, but in FAP, it is recommended because 30% to 50% of them may be associated with low grade dysplasia. […] Endoscopic follow-up for gastric adenoma should be done 6 months after incomplete polypectomy or for high grade dysplasia and 1 year for all other polyps. […] Endoscopic surveillance should be considered for stage 3 or stage 4 OLGA but the guidelines are not standardized.

• #62 Gastroenterology Education and CPD for trainees and specialists » Gastric polyps

  https://www.gastrotraining.com/gastric-polyps

  Gastric polyps are mostly asymptomatic (90%) and are typically found incidentally at OGD. Larger polyps can present with bleeding, anemia, abdominal pain or gastric outlet obstruction. […] Majority of gastric polyps are hyperplastic in nature (30-93%). […] Hyperplastic polyps should be biopsied and an examination of the whole stomach should be made for mucosal abnormalities and any abnormalities biopsied. Hyperplastic polyps rarely undergo neoplastic transformation; however there is an increased risk of neoplasia in the surrounding abnormal gastric mucosa. The risk of adenocarcinoma in the surrounding mucosa is probably higher than in the polyp itself. […] Complete removal of the adenoma should be performed when safe to do so. […] Endoscopic follow-up is required following resection of gastric adenomas. Endoscopy should be repeated at 6 months for incompletely resected polyps or those with high grade dysplasia. Endoscopy can be repeated after 1 year for all other polyps.

• #63 British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma | Gut

  https://gut.bmj.com/content/68/9/1545

  Patients with GA and GIM have an increased risk of gastric adenocarcinoma. Increased severity of atrophy and extent of intestinal metaplasia is associated with an increased risk of cancer (evidence level: moderate quality; level of agreement: 100%). […] We recommend endoscopic surveillance every 3 years should be offered to patients diagnosed with extensive GA or GIM, defined as that affecting the antrum and body (evidence level: low quality; grade of recommendation: strong; level of agreement: 100%). […] We do not recommend surveillance in patients with GA or GIM limited just to the gastric antrum; unless there are additional risk factors such as a strong family history of gastric cancer or persistent H. pylori infection, then we suggest 3-yearly surveillance (evidence level: low quality; grade of recommendation: strong; level of agreement: 93%).

• #64 Pathophysiological and clinical aspects of gastric hyperplastic polyps

  https://www.wjgnet.com/1007-9327/full/v22/i40/8883.htm

  Polypectomy is indicated for all gastric polyps 10 mm, to eliminate sampling error by missing any neoplastic foci and prevent neoplastic transformation. […] The surveillance of malignant GHPs following endoscopic removal is difficult because of the possibility of residual neoplastic cells within the stomach wall. […] Recent studies have confirmed that cancer may arise within GHP, and a malignant lesion is likely to take a hyperplasia-dysplasia-adenocarcinoma course.

• #65

  https://journals.lww.com/ajg/fulltext/2020/10001/s2937_hyperplastic_gastric_polyps,__size_matters_.2936.aspx

  Hyperplastic polyps are equally common in men and women and typically occur in the sixth and seventh decades. […] The overall prevalence of carcinoma in hyperplastic polyps is less than 2%, and it is more frequent in polyps larger than 2 cm. In view of the potential cancer risk, all hyperplastic polyps larger than 1 cm should be excised completely. Additionally, random biopsies from the intervening non-polypoid mucosa should be obtained. If present, H pylori should be eradicated and an endoscopic follow-up evaluation should be scheduled between 3 and 6 months after therapy to confirm successful eradication. The best intervals for such surveillance are unclear (e.g. annual, bi-annual, or some other interval) as is the number of years for which it should be continued.

• #66 Fundic gland polyps: Should my patient stop taking PPIs? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/90/3/157

  In general, for patients with sporadic FGPs in whom syndromic FGPs are ruled out, PPI therapy can be continued at the lowest effective dose for as long as indicated. […] However, PPI cessation should be considered if there are more than 20 polyps or polyps larger than 1 cm, especially if there are so many polyps as to give a carpeting appearance. […] Several studies suggest that if dysplasia is found in sporadic FGPs, progression to gastric cancer occurs slowly, if at all, and repeat endoscopy 1 to 3 years after polypectomy is reasonable. […] Evidence demonstrates regression of FGPs if PPIs are stopped, even if they were large in size, and endoscopic follow-up to confirm regression is unnecessary. […] If syndromic FGPs are ruled out and the patient is taking a PPI, we recommend considering PPI cessation if there are 20 or more FGPs or polyp size is larger than 1 cm. […] With increasing use of PPIs and increasing incidence of PPI-associated FGPs, updated evidence is needed to elucidate the natural history of these polyps and identify risk factors for malignant transformation.

• #67 Gastric hyperplastic polyps: a narrative review – Zouridis – Digestive Medicine Research

  https://dmr.amegroups.org/article/view/8601/html

  The risk for malignant transformation has been evaluated in detail with estimations mainly between 0.66.6% while a few studies suggest higher rates, up to 8.6% (11,42-44). […] The exact mechanism of malignant transformation has yet to be understood but multiple studies evaluating the underlying histopathology and immunochemistry tried to reveal possible underlying pathogenetic mechanisms of hyperplasia to carcinoma sequence. […] Irrespective of the underlying mechanism, multiple risk factors have been associated with neoplasia development in GHP. Older age, number of GHP detected, size, lobulation, pedunculated shape are proven to have positive correlation with dysplasia/neoplasia presence within GHP (12,19,40). H. pylori infection is also associated with increased risk for dysplasia/ neoplasia development within GHP, while eradication of the organism may even prevent malignant transformation (19). […] Due to that risk, current evidence suggest removal of GHP especially if 1 cm.

• #68 Gastric Hyperplastic Polyps – EndoCollab

  https://endocollab.com/blogs/gi-endoscopy-tips-tricks/gastric-hyperplastic-polyps/?srsltid=AfmBOoq-VK0mKXW7XqIGCiw0yJzuYLwW0gugC8I9BoaId_11KHicJu0H

  No surveillance is necessary in this patient, especially because the patient is NOT infected with H. pylori and there was no gastric atrophy. […] Hyperplastic gastric polyps larger than 10 mm should be removed as they are associated with malignancy, i.e. harboring a cancer. […] Any sized hyperplastic gastric polyp, but only in the presence of H. pylori infection, is associated with higher incidence of gastric cancer. […] Importantly, persons with H. pylori infection and non-ulcer dyspepsia, gastric ulcers, or gastric hyperplastic polyps were also at risk. […] Among the patients with H. pylori infection, those with severe gastric atrophy, corpus-predominant gastritis, and intestinal metaplasia were at significantly higher risk for gastric cancer. […] Gastric cancers were detected in 5 (2.2 percent) of the 229 with gastric hyperplastic polyps.

• #69 Risk factors and clinical correlates of neoplastic transformation in gastric hyperplastic polyps in Chinese patients | Scientific Reports

  https://www.nature.com/articles/s41598-020-58900-z

  Gastric hyperplastic polyps (GHPs) have a potential risk of neoplastic transformation, but the responsible mechanisms have not yet been established. […] GHPs have a potential risk of neoplastic transformation, so they have been classified as potentially precancerous lesions. […] The reported prevalence of dysplasia in GHPs has varied from 1.919%. […] The risk of gastric cancer developing in subjects with severe fundal atrophic gastritis was 5.76 times greater than in those having little or no fundal atrophic gastritis. […] In conclusion, GHPs are associated with the presence of AMAG, and this may be responsible for neoplastic transformation in some cases, and hypergastrinemia may contribute.

• #70 British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma | Gut

  https://gut.bmj.com/content/68/9/1545

  Patients with GA and GIM have an increased risk of gastric adenocarcinoma. Increased severity of atrophy and extent of intestinal metaplasia is associated with an increased risk of cancer (evidence level: moderate quality; level of agreement: 100%). […] We recommend endoscopic surveillance every 3 years should be offered to patients diagnosed with extensive GA or GIM, defined as that affecting the antrum and body (evidence level: low quality; grade of recommendation: strong; level of agreement: 100%). […] We do not recommend surveillance in patients with GA or GIM limited just to the gastric antrum; unless there are additional risk factors such as a strong family history of gastric cancer or persistent H. pylori infection, then we suggest 3-yearly surveillance (evidence level: low quality; grade of recommendation: strong; level of agreement: 93%).

• #71 Digestive findings that do not require endoscopic surveillance – Reducing the burden of care: ESGE Position Statement | ESGE

  https://www.esge.com/digestive-findings-that-do-not-require-endoscopic-surveillance-reducing-the-burden-of-care-esge-position-statement

  ESGE recommends against surveillance of individuals with the following: an inlet esophageal patch; Los Angeles (LA) grade A or B erosive esophagitis; or < 1 cm columnar-lined esophagus. [...] ESGE recommends against surveillance of those with intestinal metaplasia limited to the antrum unless additional risk factors are present, such as persistent Helicobacter pylori infection, incomplete metaplasia, or a family history of gastric cancer; or for fundic gland polyps in the absence of suspicious endoscopic features or hereditary syndromes. [...] ESGE recommends against surveillance of gastrointestinal leiomyomas, lipomas, and antral pancreatic rests, provided that these lesions have typical ultrasonographic features. [...] ESGE recommends against routine endoscopic surveillance in duodenal peptic ulcer, unless symptoms persist despite adequate therapy.

• #72 Is Surveillance Colonoscopy Necessary for Patients with Sporadic Gastric Hyperplastic Polyps? | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0122996

  Gastric polyps, such as adenomas and hyperplastic polyps, can be found in various colonic polyposis syndromes. […] However, until now information in patients with sporadic gastric hyperplastic polyps was limited. […] The risk of colorectal adenoma increases in patients with sporadic gastric hyperplastic polyps, and surveillance colonoscopy for these patients should be considered.

• #73 Patients with Gastric Polyps need Colonoscopy Screening at Younger Age: A Large Prospective Cross-Sectional Study in China

  https://www.jcancer.org/v10p4623.htm

  The presence of gastric polyps is significantly associated with a higher prevalence of colorectal adenomas, especially advanced colorectal adenomas. […] Colonoscopy might be considered in patients with gastric polyps, of any gender, and over the age of 40. […] Patients over the age of 40 with gastric polyps had a higher prevalence of colorectal adenomas than those without (40-49yr: OR=1.81, 95% CI=1.02-3.21, p=0.04; 50-59yr: OR=1.88, 95% CI=1.26-2.81, p0.001; 60-74yr: OR=2.62, 95% CI=1.73-3.98, p0.001). […] The current study prospectively analyzed 1546 consecutive patients and confirmed an association between gastric polyps and colorectal adenomas, especially advanced colorectal adenomas. […] A significantly higher prevalence of colorectal adenomas (29.7%) and advanced colorectal adenomas (10.0%) were observed in patients with gastric polyps compared to the matched control group (17.1% for colorectal adenomas and 4.5% for colorectal adenomas). […] The prevalence of CRC is significantly higher among patients with gastric polyps compared with the control group, which is consistent with a previous study. […] We recommend screening colonoscopy in patients of both sexes over the age of 40 with gastric polyps.

• #74 Patients with Gastric Polyps need Colonoscopy Screening at Younger Age: A Large Prospective Cross-Sectional Study in China

  https://www.jcancer.org/v10p4623.htm

  The presence of gastric polyps is significantly associated with a higher prevalence of colorectal adenomas, especially advanced colorectal adenomas. […] Colonoscopy might be considered in patients with gastric polyps, of any gender, and over the age of 40. […] Patients over the age of 40 with gastric polyps had a higher prevalence of colorectal adenomas than those without (40-49yr: OR=1.81, 95% CI=1.02-3.21, p=0.04; 50-59yr: OR=1.88, 95% CI=1.26-2.81, p0.001; 60-74yr: OR=2.62, 95% CI=1.73-3.98, p0.001). […] The current study prospectively analyzed 1546 consecutive patients and confirmed an association between gastric polyps and colorectal adenomas, especially advanced colorectal adenomas. […] A significantly higher prevalence of colorectal adenomas (29.7%) and advanced colorectal adenomas (10.0%) were observed in patients with gastric polyps compared to the matched control group (17.1% for colorectal adenomas and 4.5% for colorectal adenomas). […] The prevalence of CRC is significantly higher among patients with gastric polyps compared with the control group, which is consistent with a previous study. […] We recommend screening colonoscopy in patients of both sexes over the age of 40 with gastric polyps.

• #75 Patients with Gastric Polyps need Colonoscopy Screening at Younger Age: A Large Prospective Cross-Sectional Study in China

  https://www.jcancer.org/v10p4623.htm

  The presence of gastric polyps is significantly associated with a higher prevalence of colorectal adenomas, especially advanced colorectal adenomas. […] Colonoscopy might be considered in patients with gastric polyps, of any gender, and over the age of 40. […] Patients over the age of 40 with gastric polyps had a higher prevalence of colorectal adenomas than those without (40-49yr: OR=1.81, 95% CI=1.02-3.21, p=0.04; 50-59yr: OR=1.88, 95% CI=1.26-2.81, p0.001; 60-74yr: OR=2.62, 95% CI=1.73-3.98, p0.001). […] The current study prospectively analyzed 1546 consecutive patients and confirmed an association between gastric polyps and colorectal adenomas, especially advanced colorectal adenomas. […] A significantly higher prevalence of colorectal adenomas (29.7%) and advanced colorectal adenomas (10.0%) were observed in patients with gastric polyps compared to the matched control group (17.1% for colorectal adenomas and 4.5% for colorectal adenomas). […] The prevalence of CRC is significantly higher among patients with gastric polyps compared with the control group, which is consistent with a previous study. […] We recommend screening colonoscopy in patients of both sexes over the age of 40 with gastric polyps.

• #76 Gastric Polyps: A Review of Clinical, Endoscopic, and Histopathologic Features and Management Decisions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3992058/

  The increasing use of endoscopy has led to more discernable abnormalities in the stomach, including polyps. […] Despite their high prevalence, there is a paucity of literature to support management and treatment decisions for endoscopists. […] Gastric polyps most frequently originate in the mucosa but encompass a broad spectrum of pathologic conditions that may even be submucosal or extrinsic. […] Found in 6% of upper endoscopies, gastric polyps are a heterogeneous group of epithelial and subepithelial lesions that can vary in histology, neoplastic potential, and management. […] Most have no risk of cancer, but there are certain subsets of polyps with malignant potential, necessitating further endoscopic treatment and/or periodic surveillance. […] The recommendations for initial management and follow-up should be followed at the discretion of the endoscopist.

• #77 Gastric Polyps: A Review of Clinical, Endoscopic, and Histopathologic Features and Management Decisions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3992058/

  Due to the increased risk of malignancy associated with these polyps, recommendations include complete removal of the adenoma, with further examination of the entire gastric mucosa for abnormalities, all of which should be biopsied. […] Endoscopic follow-up is required after resection at 6 months (for incompletely resected polyps or high-grade dysplasia) or 1 year (for all other polyps). […] Gastric polyps are a common finding during routine endoscopy. […] Despite the fact that more than 90% are asymptomatic and do not have malignant potential, a subset of gastric polyps require further intervention, and histologic evaluation is necessary to determine the type of polyp and the presence of dysplasia.

• #78 British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma | Gut

  https://gut.bmj.com/content/68/9/1545

  We do not recommend the use of biomarkers as a screening tool in areas with a low incidence of gastric adenocarcinoma, such as the UK (evidence level: low quality; grade of recommendation: weak; level of agreement: 100%). […] We recommend that the number of gastric polyps (or estimated number), location of polyps and size of the largest polyp should be clearly documented (evidence level: low quality; grade of recommendation: strong; level of agreement: 100%). […] We recommend that gastric polyps other than fundic gland polyps (FGPs) should be biopsied for histopathological assessment (evidence level: low quality; grade of recommendation: strong; level of agreement: 100%). […] We recommend that photographic documentation should be undertaken for all polyps or representative polyps, if numerous (evidence level: low quality; grade of recommendation: strong; level of agreement: 100%).

• #79 British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma | Gut

  https://gut.bmj.com/content/68/9/1545

  We do not recommend the use of biomarkers as a screening tool in areas with a low incidence of gastric adenocarcinoma, such as the UK (evidence level: low quality; grade of recommendation: weak; level of agreement: 100%). […] We recommend that the number of gastric polyps (or estimated number), location of polyps and size of the largest polyp should be clearly documented (evidence level: low quality; grade of recommendation: strong; level of agreement: 100%). […] We recommend that gastric polyps other than fundic gland polyps (FGPs) should be biopsied for histopathological assessment (evidence level: low quality; grade of recommendation: strong; level of agreement: 100%). […] We recommend that photographic documentation should be undertaken for all polyps or representative polyps, if numerous (evidence level: low quality; grade of recommendation: strong; level of agreement: 100%).

• #80 British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma | Gut

  https://gut.bmj.com/content/68/9/1545

  We do not recommend the use of biomarkers as a screening tool in areas with a low incidence of gastric adenocarcinoma, such as the UK (evidence level: low quality; grade of recommendation: weak; level of agreement: 100%). […] We recommend that the number of gastric polyps (or estimated number), location of polyps and size of the largest polyp should be clearly documented (evidence level: low quality; grade of recommendation: strong; level of agreement: 100%). […] We recommend that gastric polyps other than fundic gland polyps (FGPs) should be biopsied for histopathological assessment (evidence level: low quality; grade of recommendation: strong; level of agreement: 100%). […] We recommend that photographic documentation should be undertaken for all polyps or representative polyps, if numerous (evidence level: low quality; grade of recommendation: strong; level of agreement: 100%).

• #81 Management of gastric polyps | PPT

  https://www.slideshare.net/slideshow/management-of-gastric-polyps/38608402

  All gastric polyps should be biopsied and examined microscopically for histologic characterization due to risk of cancer. Forceps biopsy alone cannot exclude foci of HGD or early gastric cancer in large (1 cm) polyps. Polypectomy is generally indicated for all neoplastic polyps and other polyps 1 cm in diameter. […] H.Pylori infection All patients with hyperplastic gastric polyps should be tested for H. pylori, if positive, treated with eradication therapy. Treatment has been associated with regression of polyps in some patients. […] Repeat gastroscopy should be performed at 1 year for all polyps with dysplasia that have not been removed. Repeat gastroscopy should be performed at 1 year following complete polypectomy for high risk polyp. […] Management of gastric polyps associated with polyposis Syndrome Life time risk of malignancy Surveillance recommendation FAP 100% (colon) OGD every 2 years after 18 Biopsy 5 polyps Remove polyps 1 cm Peutz-Jeghers 50% (extra-GI) OGD every 2 years after 18 Biopsy 5 polyps Remove polyp 1 cm Juvenile polyp 50% OGD every 3 years after 18 Cowdens Rare Eradicate H pylori No further OGD needed.

• #82 Academy of Medicine, Singapore clinical guideline on endoscopic surveillance and management of gastric premalignant lesions – Annals Singapore

  https://annals.edu.sg/academy-of-medicine-singapore-clinical-guideline-on-endoscopic-surveillance-and-management-of-gastric-premalignant-lesions/

  Statement 19: We recommend polypectomy for fundic gland polyps 1cm, hyperplastic polyps 0.5cm, and adenomatous polyps of any size when possible. Quality of evidence: Moderate Strength of recommendation: Strong Agreement: 100% […] Statement 20: We recommend that in the setting of multiple hyperplastic polyps or adenomatous polyps, surrounding gastric mucosa should be assessed for synchronous neoplasia, and biopsies taken for the assessment of H. pylori infection, atrophic gastritis and intestinal metaplasia. Quality of evidence: Moderate Strength of recommendation: Strong Agreement: 89% […] Statement 21: We suggest surveillance endoscopy 1 year after complete endoscopic excision of dysplastic or adenomatous polyps. Quality of evidence: Low Strength of recommendation: Weak Agreement: 95%

• #83 Gastric polyps: a 10-year analysis of 18,496 upper endoscopies | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-022-02154-8

  In our study, the GPs frequency was 0.36%. Hyperplastic polyps and fundic gland are the most common in our country. […] Gastric polyps are usually discovered incidentally during esophagogastroduodenoscopies (EGD) and their prevalence is estimated from 0.5 to 23% of all upper gastrointestinal endoscopies. […] The majority of polyps are benign (85% of cases). The risk of malignancy or malignant transformation of gastric polyps depends on their histological nature. […] Hyperplastic polyps are associated with chronic gastritis such as H. pylori gastritis, and particularly autoimmune gastritis. […] In our study, adenomas were detected in seven patients (5.5%). […] Hyperplastic polyps should be biopsied according to the British society of gastroenterology and an examination of the whole stomach should be made. H pylori infection should be detected and eradicated when present. […] Guidelines on management of hyperplastic polyps, recommend resection of polyps greater than 5 mm. […] Polypectomy is not required for sporadic fundic gland polyps.

• #84 Academy of Medicine, Singapore clinical guideline on endoscopic surveillance and management of gastric premalignant lesions – Annals Singapore

  https://annals.edu.sg/academy-of-medicine-singapore-clinical-guideline-on-endoscopic-surveillance-and-management-of-gastric-premalignant-lesions/

  Statement 19: We recommend polypectomy for fundic gland polyps 1cm, hyperplastic polyps 0.5cm, and adenomatous polyps of any size when possible. Quality of evidence: Moderate Strength of recommendation: Strong Agreement: 100% […] Statement 20: We recommend that in the setting of multiple hyperplastic polyps or adenomatous polyps, surrounding gastric mucosa should be assessed for synchronous neoplasia, and biopsies taken for the assessment of H. pylori infection, atrophic gastritis and intestinal metaplasia. Quality of evidence: Moderate Strength of recommendation: Strong Agreement: 89% […] Statement 21: We suggest surveillance endoscopy 1 year after complete endoscopic excision of dysplastic or adenomatous polyps. Quality of evidence: Low Strength of recommendation: Weak Agreement: 95%

• #85 Gastroenterology Education and CPD for trainees and specialists » Gastric polyps

  https://www.gastrotraining.com/gastric-polyps

  There is no evidence as to whether gastric polyps need long term surveillance, and given the cost implications of such a programme, only a single gastroscopy 1 year after the removal of polyps with dysplasia is recommended (in the absence of polyp syndromes). Single repeat gastroscopy should also be performed at 1 year for all polyps with dysplasia that have not been removed.

• #86 Differential Diagnoses and Management Approaches for Gastric Polyposis

  https://www.mdpi.com/2036-7422/15/1/9

  Given the increased risk of progression of these polyps to gastric adenocarcinoma, individuals with GAPPS require regular monitoring and surveillance, including endoscopic examinations. […] Although the polyps are of a non-neoplastic nature, sporadic instances of cancer development have been documented. […] It is important to note that a patient’s medical and medication history, family history, and specific combination of symptoms are crucial for an accurate diagnosis. […] Once a diagnosis is established, tailored surveillance is imperative for each specific disorder, given the varying propensity for concomitant conditions, particularly in the organs predisposed to malignant neoplasms.

• #87 Management of gastric polyps | PPT

  https://www.slideshare.net/slideshow/management-of-gastric-polyps/38608402

  All gastric polyps should be biopsied and examined microscopically for histologic characterization due to risk of cancer. Forceps biopsy alone cannot exclude foci of HGD or early gastric cancer in large (1 cm) polyps. Polypectomy is generally indicated for all neoplastic polyps and other polyps 1 cm in diameter. […] H.Pylori infection All patients with hyperplastic gastric polyps should be tested for H. pylori, if positive, treated with eradication therapy. Treatment has been associated with regression of polyps in some patients. […] Repeat gastroscopy should be performed at 1 year for all polyps with dysplasia that have not been removed. Repeat gastroscopy should be performed at 1 year following complete polypectomy for high risk polyp. […] Management of gastric polyps associated with polyposis Syndrome Life time risk of malignancy Surveillance recommendation FAP 100% (colon) OGD every 2 years after 18 Biopsy 5 polyps Remove polyps 1 cm Peutz-Jeghers 50% (extra-GI) OGD every 2 years after 18 Biopsy 5 polyps Remove polyp 1 cm Juvenile polyp 50% OGD every 3 years after 18 Cowdens Rare Eradicate H pylori No further OGD needed.

• #88 Gastric Polyps: A Review of Clinical, Endoscopic, and Histopathologic Features and Management Decisions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3992058/

  The increasing use of endoscopy has led to more discernable abnormalities in the stomach, including polyps. […] Despite their high prevalence, there is a paucity of literature to support management and treatment decisions for endoscopists. […] Gastric polyps most frequently originate in the mucosa but encompass a broad spectrum of pathologic conditions that may even be submucosal or extrinsic. […] Found in 6% of upper endoscopies, gastric polyps are a heterogeneous group of epithelial and subepithelial lesions that can vary in histology, neoplastic potential, and management. […] Most have no risk of cancer, but there are certain subsets of polyps with malignant potential, necessitating further endoscopic treatment and/or periodic surveillance. […] The recommendations for initial management and follow-up should be followed at the discretion of the endoscopist.

• #89 Optimal Endoscopic Treatment and Surveillance of Serrated Polyps

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl19202

  US MSTF and ESGE recommend surveillance period of 1 year and 3 years respectively. […] In previous guidelines it was not possible to comment on how to assign surveillance intervals when serrated lesions occurred together with adenomas and whether risk, and therefore surveillance intervals, should be considered separately for each polyp class or if their risk was additive. […] Adequate resection technique and appropriate surveillance of serrated polyps is of utmost importance as they are a major reason behind interval cancers and failure of screening colonoscopy in preventing right sided colon cancers.

• #90 Fundic gland polyps: Should my patient stop taking PPIs? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/90/3/157

  In general, for patients with sporadic FGPs in whom syndromic FGPs are ruled out, PPI therapy can be continued at the lowest effective dose for as long as indicated. […] However, PPI cessation should be considered if there are more than 20 polyps or polyps larger than 1 cm, especially if there are so many polyps as to give a carpeting appearance. […] Several studies suggest that if dysplasia is found in sporadic FGPs, progression to gastric cancer occurs slowly, if at all, and repeat endoscopy 1 to 3 years after polypectomy is reasonable. […] Evidence demonstrates regression of FGPs if PPIs are stopped, even if they were large in size, and endoscopic follow-up to confirm regression is unnecessary. […] If syndromic FGPs are ruled out and the patient is taking a PPI, we recommend considering PPI cessation if there are 20 or more FGPs or polyp size is larger than 1 cm. […] With increasing use of PPIs and increasing incidence of PPI-associated FGPs, updated evidence is needed to elucidate the natural history of these polyps and identify risk factors for malignant transformation.

• #91 Gastric Cancer Prevention: New AGA Update Reflects Latest High-Risk Screening and Surveillance Advice | MDedge

  https://www.mdedge.com/gihepnews/article/272500/gi-oncology/gastric-cancer-prevention-new-aga-update-reflects-latest-high-risk-screening-and-surveillance-advice

  Stomach polyps are commonly found during routine endoscopic procedures. They are mostly asymptomatic and incidental, and therefore, clinicians may not be prepared ahead of time on how to deal with them. […] Recent changes in the epidemiology and endoscopic management of gastric polyps makes this update timely and important. […] This update provides clinicians with a framework for understanding the natural history and epidemiology of gastric polyps, as well as guidance on best practices for the endoscopic detection and classification of gastric polyps, best practices for the endoscopic resection of gastric polyps, and best practices for endoscopic surveillance following resection.

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