Table 2 Recommendations, rationale, and potential actions for gastric cancer prevention and control in Chile (and the Americas).

Strengthen population-based cancer registries

As the epidemiology of GC is changing in the Americas, periodical, and detailed registry-based analyses are required

The Chilean Cancer Law now requires a national cancer registry. High-quality and comprehensive cancer registries will ensure that policymakers have accurate and timely data on incidence, treatment, and survivorship to make decisions based on evidence

Implement a sustainable registry with good national coverage and adequate funding

Establish new population-based registries in high-risk areas with no coverage

Support development and dissemination of standards for quality care

High quality must be a requirement for health care providers in Chile

In collaboration with the Ministry of Health, clinical and academic societies promote multidisciplinary and establish combined operational guidelines and promote consistent reporting of histopathologic findings

Enable training of health care workforce

Trained health providers can effectively limit morbidity and mortality associated with GC

Establish high-level training for health providers in areas of H. pylori eradication and endoscopy practice and biopsy taking

Establish H. Pylori management registration and a surveillance system of antibiotic resistance

Promote quadruple clarithromycin-based therapies. Registry data of H. pylori for the selection of regimens to be used in each population based on studies of antibiotic resistance in the same population

Establish a large-scale long-term prospective registry of H. pylori-positive patients receiving eradication therapy

Perform endoscopic campaigns in high-risk populations (e.g. rural areas), focusing on individuals with major risk factors

Mobile screening services have served to expand access to cancer screening in diverse contexts as individuals in lower socioeconomic and indigenous groups exhibit higher risk of GC incidence and mortality

Perform endoscopic campaigns focused on high-risk individuals (i.e., adults aged ≥ 50 years, male sex, smokers, family history of GC) and ideally symptomatic

Strengthen strategies to reduce salt (sodium) intake

High salt intake increases the risk of GC by synergizing with the pathogenic effects of chronic H. pylori infection

Adopt WHO recommendations for salt intake reduction to reinforce salt reduction interventions in primary-care settings