Published online Jul 21, 2019. doi: 10.3748/wjg.v25.i27.3546
Peer-review started: March 11, 2019
First decision: May 9, 2019
Revised: May 28, 2019
Accepted: June 22, 2019
Article in press: June 23, 2019
Published online: July 21, 2019
Core tip: Current evidence shows that patients with gastric dysplasia, severe and extensive gastric atrophy, extensive gastric intestinal metaplasia and the incomplete subtype of intestinal metaplasia are at high risk for gastric cancer development. Key issues in selecting approaches to identifying these subjects are the ability to reduce gastric cancer mortality and cost-effectiveness of the approach. Resource limitations are an important barrier in many regions worldwide. Thus, an applicable approach in real-life practice should be not only evidence-based but also resource-sensitive. In this review, we discuss the current understanding from western and eastern perspectives, and the possibility of an integrated, resource-sensitive approach.