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Geographical differences have been shown in the clinical outcomes of Helicobacter pylori-associated gastritis phenotypes and in gastric cancer risk. This study tested whether the Operative Link on Gastritis Assessment (OLGA) staging correlated with gastric cancer risk in populations from 3 continents. Mapped gastric biopsies were obtained from 316 dyspeptic adults aged less than 41 years from 8 geographic areas that differed in gastric cancer risk. Gastric atrophy was assessed according to internationally validated criteria. Gastritis stage was established according to the OLGA staging system. The most prevalent gastritis stages were 0 to II, which included all subjects entered from Chile, Germany, India, Italy, and Thailand. Gastritis Stages III and IV were limited to the Chinese and Korean populations. Indians had a high prevalence of H pylori infection without high-stage gastritis. In populations at different cancer risk, the gastritis OLGA stage mirrored the gastric cancer incidence. Gastritis staging identifies a subgroup of higher-risk patients.

A worldwide concern has emerged with regard to endoscope disinfection, and many gastrointestinal endoscopy associations have guidelines for proper disinfection of endoscopes and endoscopic accessories. They are not much different from those of the American Society of Gastrointestinal Endoscopy and include mechanical cleaning as the first and most important step followed by immersion in 2% glutaraldehyde for periods ranging from 5 to 20 minutes. Lack of compliance with these guidelines has been noted, however, in 20 to 70% of centers in Europe, the United Kingdom, Australia, and Asia. Automated disinfectors are being universally recommended to ensure better compliance. Two other improvements are use of peracetic acid as an alternative disinfectant and use of a disposable sheath over the endoscope.