{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:54:05Z","timestamp":1792479245216,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":35,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Gastric cancer remains a major global health concern and is still frequently diagnosed at advanced stages in Western countries. Despite increasing evidence supporting the role of endoscopic screening in intermediate\u2010risk regions such as Portugal, no national program currently exists. This study aimed to evaluate the feasibility, adherence, and diagnostic yield of opportunistic upper endoscopy performed simultaneously with colorectal cancer screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>We conducted an observational retrospective study including individuals aged 50\u201374\u2009years scheduled for a screening colonoscopy, who were invited to undergo an additional upper gastrointestinal endoscopy, between February 2023 and February 2025 in two endoscopy units in the Alentejo region of Portugal. Data regarding demographics, endoscopic findings, and histology were collected and analyzed descriptively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 401 individuals invited, 380 (94.8%) accepted and underwent upper endoscopy, and 377 were included in the final analysis. Histological findings included <jats:styled-content style=\"fixed-case\"><jats:italic>Helicobacter pylori<\/jats:italic><\/jats:styled-content> infection (30.8%), chronic atrophic gastritis (36.9%) and intestinal metaplasia (10.1%). Regarding neoplastic lesions, 2 cases (0.5%) of low\u2010grade intraepithelial neoplasia, 3 cases (0.8%) of gastric adenocarcinoma, and 2 cases (0.5%) of gastrointestinal stromal tumors were identified, yielding a total malignancy rate of 1.9%; no early gastric cancers were identified. Colorectal findings included 29.2% precancerous lesions and 3.4% invasive colorectal cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study confirms that opportunistic upper endoscopic screening, integrated into colorectal cancer\u2010screening programs, is feasible, well accepted, and diagnostically valuable in an intermediate\u2010risk Western population. The high rate of precancerous conditions and malignant lesions detected reinforces the need for structured screening strategies. These results align with international recommendations and provide real\u2010world evidence to support broader implementation in similar healthcare contexts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Registration<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>: NCT06316882<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.70061","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T11:58:57Z","timestamp":1754395137000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Gastric Cancer Endoscopic Screening in an Intermediate\u2010Risk Country\u2014A Dual\u2010Center Pilot Program"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9242-1560","authenticated-orcid":false,"given":"M. B.","family":"Mourato","sequence":"first","affiliation":[{"name":"NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, LA\u2010REAL, CCAL NOVA University Lisbon  Lisbon Portugal"},{"name":"Unidade Local de Sa\u00fade Do Alto Alentejo Hospital Doutor Jos\u00e9 Maria Grande  Portalegre Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6980-3675","authenticated-orcid":false,"given":"N.","family":"Pratas","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade Do Alto Alentejo Hospital Doutor Jos\u00e9 Maria Grande  Portalegre Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0811-1444","authenticated-orcid":false,"given":"A.","family":"Branco Pereira","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade Do Alto Alentejo Hospital Doutor Jos\u00e9 Maria Grande  Portalegre Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0565-4498","authenticated-orcid":false,"given":"F.","family":"Costa Pinto","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade Do Alto Alentejo Hospital Doutor Jos\u00e9 Maria Grande  Portalegre Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2101-0027","authenticated-orcid":false,"given":"R.","family":"Dinis","sequence":"additional","affiliation":[{"name":"Hospital do Esp\u00edrito Santo de \u00c9vora  \u00c9vora Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1406-4585","authenticated-orcid":false,"given":"I.","family":"Fronteira","sequence":"additional","affiliation":[{"name":"NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, LA\u2010REAL, CCAL NOVA University Lisbon  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9787-8175","authenticated-orcid":false,"given":"M.","family":"Areia","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas de Oncologia de Coimbra  Coimbra Portugal"},{"name":"RISE@CI\u2010IPO (Health Research Network) Portuguese Oncology Institute of Porto (IPO Porto)  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"International Agency for Research on Cancer \u201cGlobal Cancer Observatory 2022 \u2013 Stomach \u201d(2022) https:\/\/gco.iarc.fr\/today\/en\/dataviz\/maps\u2010heatmap?mode=population&cancers=7."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyy077"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2006.07.016"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2022.2068966"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.21664"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2023.100741"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-2529-5025"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.07.031"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1158\/1940-6207.CAPR-19-0422"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-020-01517-3"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.812"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2018-318126"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1104-5245"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2021.101735"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640617722902"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010147\u20108\u2010200710160\u201000010"},{"key":"e_1_2_12_19_1","unstructured":"\u201cClinical Trials.gov \u201dhttps:\/\/clinicaltrials.gov."},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-113128"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-861352"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.12230"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12150"},{"key":"e_1_2_12_24_1","unstructured":"\u201cTOGAS \u2013 Towards Gastric Cancer Screening Implementation in the European Union \u201dhttps:\/\/www.togas.lu.lv."},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0000000000000183"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-115408"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2022.2035810"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.652574"},{"issue":"1","key":"e_1_2_12_29_1","first-page":"18","article-title":"Effectiveness of Systematic Chromoendoscopy for Diagnosis of Early Cancer and Gastric Premalignant Lesions. Results of Two Consecutive Screening Campaigns in Colombia (2006\u20132007)","volume":"25","author":"Emura F.","year":"2010","journal-title":"Revista Colombiana de Gastroenterolog\u00eda"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2024.04.035"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1158\/1940-6207.CAPR-19-0372"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2015.09.013"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lansea.2024.100370"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1728-5673"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-046134"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12803"},{"key":"e_1_2_12_37_1","first-page":"251","article-title":"Effectiveness of One\u2010Time Endoscopic Screening Programme in Prevention of Upper Gastrointestinal Cancer in China: A Multicentre Population\u2010Based Cohort Study","volume":"70","author":"Chen R.","year":"2020","journal-title":"Gut"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.7314\/APJCP.2012.13.4.1407"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.57.1.37"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000021832"}],"container-title":["Helicobacter"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hel.70061","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T04:24:17Z","timestamp":1756787057000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hel.70061"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":39,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/hel.70061"],"URL":"https:\/\/doi.org\/10.1111\/hel.70061","archive":["Portico"],"relation":{},"ISSN":["1083-4389","1523-5378"],"issn-type":[{"value":"1083-4389","type":"print"},{"value":"1523-5378","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-05-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70061"}}