Although the Sydney System protocol requires separate biopsy sampling from
antrum, incisura, and corpus, less than 4% of U.S. endoscopists adhere
to these recommendations.
There are significant differences in the prevalence of
H. pylori and gastric preneoplastic lesions amongst the major ethnic groups in the
United States. These differences tend to parallel the reported incidence
rates of gastric cancer in the ancestral countries.
It is unclear whether U.S. gastroenterologists serving multicultural populations
are aware of and take into consideration their patients’ ethnic
origin in the approach to the prevention and early detection of gastric
cancer. Specifically, it is unknown whether they adjust their biopsy sampling
practice for the maximal detection of preneoplastic gastric lesions in
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