OBJECTIVE: Upper gastrointestinal complaints are common in the general population. The aim of this study was to establish whether age and occurrence of alarm symptoms are predictors of malignancy in primary care open-access endoscopy. MATERIAL AND METHODS: The material comprised 10,061 consecutive patients referred for gastroscopy by general practitioners from 1989 to 2000. The presenting symptoms were recorded; alarm symptoms comprised dysphagia, weight loss, gastrointestinal bleeding, anaemia and vomiting. RESULTS: In all, 13.0% (1310) of the patients had alarm symptoms. Malignancy was detected in 0.7% (72 patients) in the whole series, in 0.3% (13 patients) aged 55 years or younger and in 1.1% (59 patients) over 55 years of age; the respective percentages in patients with alarm symptoms were 2.5% (33 patients), 1.0% (5 patients) and 3.4% (28 patients). Alarm symptoms (odds ratios 3.98; confidence interval 2.47-6.41), age (1.07/year; 1.05-1.09) and male gender (1.95; 1.22-3.12) were significantly associated with gastrointestinal malignancy. CONCLUSIONS: The total number of malignancies in the primary care open-access gastroscopy series was low. Alarm symptoms increased the risk 5-6-fold; such patients should therefore undergo endoscopy without delay. At a further one year of age the risk was increased by 7%, but no definite age limit for endoscopy could be asserted.
OBJECTIVE: Upper gastrointestinal complaints are common in the general population. The aim of this study was to establish whether age and occurrence of alarm symptoms are predictors of malignancy in primary care open-access endoscopy. MATERIAL AND METHODS: The material comprised 10,061 consecutive patients referred for gastroscopy by general practitioners from 1989 to 2000. The presenting symptoms were recorded; alarm symptoms comprised dysphagia, weight loss, gastrointestinal bleeding, anaemia and vomiting. RESULTS: In all, 13.0% (1310) of the patients had alarm symptoms. Malignancy was detected in 0.7% (72 patients) in the whole series, in 0.3% (13 patients) aged 55 years or younger and in 1.1% (59 patients) over 55 years of age; the respective percentages in patients with alarm symptoms were 2.5% (33 patients), 1.0% (5 patients) and 3.4% (28 patients). Alarm symptoms (odds ratios 3.98; confidence interval 2.47-6.41), age (1.07/year; 1.05-1.09) and male gender (1.95; 1.22-3.12) were significantly associated with gastrointestinal malignancy. CONCLUSIONS: The total number of malignancies in the primary care open-access gastroscopy series was low. Alarm symptoms increased the risk 5-6-fold; such patients should therefore undergo endoscopy without delay. At a further one year of age the risk was increased by 7%, but no definite age limit for endoscopy could be asserted.
Authors: Emre Günay; Erkan Özkan; Hacı Mehmet Odabaşı; Hacı Hasan Abuoğlu; Cengiz Eriş; Mehmet Kamil Yıldız; Süleyman Atalay Journal: Ulus Cerrahi Derg Date: 2013-09-01
Authors: Judith J de Jong; Marten A Lantinga; Ina M E Thijs; Philip R de Reuver; Joost P H Drenth Journal: Therap Adv Gastroenterol Date: 2020-11-04 Impact factor: 4.409
Authors: Claire Friedemann Smith; Alice C Tompson; Nicholas Jones; Josh Brewin; Elizabeth A Spencer; Clare R Bankhead; Fd Richard Hobbs; Brian D Nicholson Journal: Br J Gen Pract Date: 2018-08-13 Impact factor: 5.386
Authors: Margaret P Astin; Tanimola Martins; Nicky Welton; Richard D Neal; Peter W Rose; William Hamilton Journal: Br J Gen Pract Date: 2015-10 Impact factor: 5.386