<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-9957</journal-id>
<journal-title><![CDATA[Revista colombiana de Gastroenterología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Col Gastroenterol]]></abbrev-journal-title>
<issn>0120-9957</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Gastroenterología  ]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-99572019000200177</article-id>
<article-id pub-id-type="doi">10.22516/25007440.394</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Cáncer gástrico: una enfermedad prevenible. Estrategias para intervención en la historia natural]]></article-title>
<article-title xml:lang="en"><![CDATA[Gastric cancer is a preventable disease: Strategies for intervention in its natural history]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Oliveros]]></surname>
<given-names><![CDATA[Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pinilla]]></surname>
<given-names><![CDATA[Raúl E.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Facundo Navia]]></surname>
<given-names><![CDATA[Helena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez Pedraza]]></surname>
<given-names><![CDATA[Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Cancerología  ]]></institution>
<addr-line><![CDATA[Bogotá D. C]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional de Colombia  ]]></institution>
<addr-line><![CDATA[Bogotá D. C]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<volume>34</volume>
<numero>2</numero>
<fpage>177</fpage>
<lpage>189</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-99572019000200177&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-99572019000200177&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-99572019000200177&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El cáncer gástrico es un problema de salud pública. Las cifras de mortalidad y supervivencia son impresentables en nuestro país. En Colombia no existe ningún programa ni estrategias de diagnóstico temprano, ni tampoco es priorizado como un problema de salud. Los trabajos existentes demuestran que la mayoría de los pacientes cuando son diagnosticados presentan estadios avanzados. Un 90 % de los canceres gástricos se consideran consecuencia de un largo proceso inflamatorio sobre la mucosa gástrica. La infección por Helicobacter pylori es la principal etiología de la gastritis, la cual puede progresar a atrofia, metaplasia, displasia y cáncer. La atrofia gástrica establece un campo de cancerización más propenso a cambios moleculares y fenotípicos que terminan en un cáncer en crecimiento. Es claro que la historia natural proporciona un racional entendimiento clínico patológico para estrategias de prevención primaria y secundaria. Una evidencia bien establecida demuestra que la combinación de las estrategias primarias (erradicación del H. pylori) y secundarias (diagnóstico y seguimiento endoscópico de lesiones premalignas) pueden prevenir o limitar la progresión de la carcinogénesis gástrica. El riesgo de cáncer gástrico asociado con la gastritis por H. pylori puede ser estratificado de acuerdo con la gravedad y extensión de la atrofia de la mucosa gástrica. Esta aproximación está adaptada a diferentes países, de acuerdo con su incidencia específica de cáncer gástrico, condición socioeconómica y factores culturales, que requiere de la participación complementaria de los gastroenterólogos, los cirujanos, los oncólogos y patólogos. Frente a este problema de salud pública no hay ninguna acción por parte de las autoridades de salud ni del gremio médico. Por tanto, se revisan las estrategias de manejo que permitan intervenir la historia natural de la enfermedad con el objetivo de disminuir la incidencia y mortalidad. La implementación y estandarización de estas estrategias de manejo en nuestro medio podrán beneficiar a los pacientes con riesgo incrementado para cáncer gástrico y pueden implementarse (en países sin programas de tamizaje) de una forma racional, similar a como se está haciendo con el cáncer colorrectal, en todo el mundo.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Gastric cancer is a public health problem, but there are no usable mortality and survival statistics for Colombia. The country has no early diagnosis program or strategy, and gastric cancer is not prioritized as a health problem. Existing studies show that most patients are in advanced stages by the time they are diagnosed. Ninety percent of gastric cancers are considered to be consequences of long inflammatory processes in the gastric mucosa. H Pylori infections are the most common etiology of gastritis which can progress to atrophy, metaplasia, dysplasia and cancer. Gastric atrophy establishes a cancerization field which is prone to molecular and phenotypic changes that end in cancerous growth. It is well understood that a disease&#8217;s natural history provides a rational pathological clinical understanding for primary and secondary prevention strategies. Well-established evidence shows that the combination of primary (H pylori eradication) and secondary strategies (diagnosis and endoscopic follow-up of pre-malignant lesions) can prevent or limit the progression of gastric carcinogenesis. The risk of gastric cancer associated with H pylori gastritis can be stratified according to the severity and extent of atrophy of the gastric mucosa. This approach has been adapted to many different countries according to specific incidences of gastric cancer, socio-economic conditions and cultural factors. This requires the complementary participation of gastroenterologists, surgeons, oncologists and pathologists. In the face of this public health problem, there has been no action by health authorities or the medical association. For this reason, we have reviewed management strategies that allow intervening into the natural history of the disease to reduce its incidence and mortality rate. The implementation and standardization of these management strategies in our environment may benefit patients who are at high risk for gastric cancer. These strategies can be implemented in a rational way, similar to what is being done with rectal cancer, in countries without screening programs all over the world.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Cáncer gástrico]]></kwd>
<kwd lng="es"><![CDATA[Helicobacter pylori]]></kwd>
<kwd lng="es"><![CDATA[prevención]]></kwd>
<kwd lng="es"><![CDATA[historia natural]]></kwd>
<kwd lng="en"><![CDATA[Gastric cancer]]></kwd>
<kwd lng="en"><![CDATA[helicobacter pylori]]></kwd>
<kwd lng="en"><![CDATA[prevention]]></kwd>
<kwd lng="en"><![CDATA[natural history]]></kwd>
</kwd-group>
</article-meta>
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