Gastric cancer (GC) is one of the leading cancers in Vietnam. About one third of patients with advanced GC have undergone gastroscopy within the last 6 years, partly because the present diagnostic system fails to identify subjects at high risk. In addition, the lack of official recommendations for the surveillance of gastric precancerous conditions (i.e. atrophy and intestinal metaplasia) makes the issue further confusing. There have been remarkable advances in this issue over the past 5 years, especially with the development of European guidelines on the management of gastric precancerous conditions and lesions (MAPS). Studies in Vietnamese population have shown that the assessment of endoscopic gastric atrophy (EGA) according to Kimura - Takemoto classification could help to identify patients who are at high risk, guide endoscopists on. whom to perform systematic biopsy, is appropriate and take full advantage of the low~cost, widespread gastroscopy network in Vietnam. Pathologically, the Operative Link on Gastritis Assessment (OLGA system) has also been proved to be a useful tool to identify patients at high risk in several populations including Vietnamese. Formal training for the assessment of EGA and OLGA gastritis is, therefort:, crucial to solve this issue. In clinical practice when OLGA gastritis assessment is not yet available, taking 3 specimens along the lesser curvature according to the updated Sydney system (carried in different vials) has been shown to be enough for assessing the extension of gastric atrophy and intestinal metaplasia so that to make an individual surveillance according to MAPS. Future studies in Vietnam should focus on this issue in order to develop a guidelines which is most appropriate for our population.
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