APAGE Position Statements on Green and Sustainability in Gastroenterology, Hepatology, and Gastrointestinal Endoscopy.
Journal
Journal of gastroenterology and hepatology
Journal Volume
40
Journal Issue
4
Start Page
821
End Page
831
ISSN
1440-1746
Date Issued
2025-04
Author(s)
Ang, Tiing Leong
Hang, Dao Viet
Li, James Weiquan
Ho, Jacky Chiu Leung
Sy-Janairo, Marianne Linley
Raja Ali, Raja Affendi
Makharia, Govind K
Sundaram, Sridhar
Chantarojanasiri, Tanyaporn
Kim, Hyun-Gun
Isayama, Hiroyuki
Pausawasdi, Nonthalee
Wu, Kaichun
Syam, Ari Fahrial
Aye, Than Than
Rehman, Sher
Niriella, Madunil Anuk
Jurawan, Ricardo
Wang, Liangjing
Leung, Wai Keung
Rizan, Chantelle
Wu, Justin Che Yuen
Ooi, Choon Jin
Abstract
Background and Aim: The APAGE Position Statements aimed to provide guidance to healthcare practitioners on clinical practices aligned with climate sustainability. Methods: A taskforce convened by APAGE proposed provisional statements. Twenty-two gastroenterologists from the Asian Pacific region participated in online voting and consensus was assessed through an anonymized and iterative Delphi process. Results: There were five sections that addressed the rationale for climate action, the importance of adopting principles of waste management, clinical practice, gastrointestinal endoscopy, and issues related to advocacy and research. Sixteen statements achieved consensus and included the following: 1. APAGE recommends adopting prompt measures to reduce the carbon footprint of clinical practice due to the importance of climate action and its health cobenefits. 5. APAGE recommends adherence to professional clinical guidelines to optimize clinical care delivery in gastroenterology and hepatology to avoid the environmental impact of unnecessary procedures and tests. 8. APAGE recommends an emphasis on health promotion, disease prevention, and appropriate screening and surveillance, when resources are available, to reduce the environmental impact of managing more advanced diseases that require more intensive resources. 12. APAGE recommends that technological advances in endoscopic imaging and artificial intelligence, when available, be used to improve the precision of endoscopic diagnosis to reduce the risk of missed lesions and need for unnecessary biopsies. 13. APAGE recommends against the routine use of single-use endoscopes. Conclusion: The position statements provide guidance to healthcare practitioners on clinical practices in gastroenterology, hepatology, and endoscopy that promote climate sustainability.
Subjects
climate change
endoscopy
gastroenterology
hepatology
Type
review article