The Asociación Mexicana de Gastroenterología convened 20 specialists in gastroenterology, oncology, endoscopy, epidemiology and public health to produce a consensus position statement on early detection and referral of oesophageal, gastric and colorectal cancer from primary care.
It issues 13 statements covering alarm features, risk factors, recommended investigations and risk-stratified referral as urgent, priority or elective, with an algorithm for each cancer. It emphasises upper endoscopy and high-quality colonoscopy as the diagnostic tests of choice in symptomatic patients, distinguishing these from population screening.
The statement is written for the Mexican health system, but the problem it addresses — late referral of patients with alarm features — is shared by India, where gastric and oesophageal cancers often present late. A tiered referral pathway is the transferable idea.
- Refer patients with dysphagia, GI bleeding, iron deficiency anaemia or unexplained weight loss for prompt endoscopy.
- Use a tiered system — urgent, priority, elective — so alarm features are seen first.
- Treat symptomatic patients as needing diagnostic endoscopy, not screening tests.
- Insist on high-quality colonoscopy for diagnosis.
Why it matters
Delays between primary care and endoscopy are a major reason GI cancers are found late.
Don't overread it
This is expert consensus for one health system, not new trial evidence.
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