Abstract
<jats:p>Precancerous conditions of the gastric mucosa — atrophic gastritis, intestinal metaplasia, and dysplasia — are key components of the gastric carcinogenesis cascade and determine the need for timely diagnosis and rational surveillance. This review summarizes current approaches to the detection and risk stratification of precancerous gastric lesions, with particular emphasis on the MAPS III recommendations. It discusses the capabilities of white-light endoscopy and image-enhanced endoscopy (virtual chromoendoscopy), the principles of targeted and systematic biopsy according to the Sydney protocol, as well as the role of the standardized histological staging systems OLGA/OLGIM and the endoscopic grading system for intestinal metaplasia, EGGIM, in predicting the risk of gastric cancer. Special attention is paid to the practical aspects of implementing these approaches in Ukraine, including the availability of technologies, the need for endoscopist training, ensuring the quality of morphological verification, and the organization of patient referral pathways. This review may be useful for unifying diagnostic strategies and improving the effectiveness of secondary prevention of gastric cancer in real-world clinical practice.</jats:p>