Table 27.

Statements pertaining to gastric adenocarcinoma and proximal polyposis of the stomach—extended version

Statements
GAPPS.1 Regarding GAPPS, who should be offered genetic testing? Genetic testing should be offered to individuals with a clinical suspicion of GAPPS.
GAPPS.2 When should endoscopic surveillance of the upper-GI tract be performed in GAPPS syndrome? A: The age to start upper GI surveillance in asymptomatic individuals at risk of gastric cancer should be evaluated on a case-by-case basis. The youngest age of gastric cancer in the family should be considered. B: Surveillance endoscopic intervals for GAPPS families should be flexible and decided on a case-by-case basis.
GAPPS.3 Is surveillance of the colon and rectum indicated in GAPPS patients? In GAPPS patients CRC surveillance may be considered, particularly when there is a family history of CRC.
GAPPS.4 Which treatment modalities are available for GAPPS? A: GAPPS results in a high risk of gastric cancer. Total gastrectomy should be considered in cases of high-grade dysplasia and progressive gastric polyposis. B: There is not enough evidence to recommend an age for risk-reducing prophylactic gastrectomy: the decision should be individualized.

CRC, colorectal cancer; GAPPS, gastric adenocarcinoma and proximal polyposis of the stomach; GI, gastrointestinal.