Georgina Chadwick1, Oliver Groene2, Stuart Riley3, Richard Hardwick4, Tom Crosby5, Jonathan Hoare6, George B Hanna7, Kimberley Greenaway8, David A Cromwell2. 1. Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, United Kingdom; Department of Surgery and Cancer, Imperial College, London, United Kingdom. Electronic address: gchadwick@rcseng.ac.uk. 2. Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, United Kingdom; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom. 3. Department of Gastroenterology, Northern General Hospital, Sheffield, United Kingdom. 4. Department of Surgery, Addenbrookes Hospital, Cambridge, United Kingdom. 5. Velindre Cancer Centre, Cardiff, Wales. 6. Department of Gastroenterology, St Marys Hospital, London, United Kingdom. 7. Department of Surgery and Cancer, Imperial College, London, United Kingdom. 8. Health and Social Care Information Centre, Leeds, United Kingdom.
Abstract
BACKGROUND & AIMS: Single-center studies have estimated that 4.6% to 25.8% of gastric cancers are missed at endoscopy. We performed a population-based study to make a more precise estimate of factors associated with missed lesions in England. METHODS: We performed a retrospective population-based observational cohort study of 2727 patients diagnosed with gastric cancer from April 2011 through March 2012 in England, using linked records from 3 national data sets. The primary outcome was the proportion of patients who had undergone endoscopy in the 3 to 36 months before a diagnosis of gastric cancer. We determined this proportion for the entire cohort and for subgroups. RESULTS: Of the 2727 patients in the cohort, 8.3% (95% confidence interval, 7.2%-9.3%) underwent endoscopic evaluation in the 3 to 36 months before their diagnosis of gastric cancer. An endoscopy within 3 to 36 months of diagnosis was associated with a diagnosis of early stage cancer (stages 0 or 1, 11.5%; stage 2, 7.9%; stages 3 or 4, 6.9%; P = .01 for stage 0 or 1 vs stage 2 or greater), younger age at diagnosis (<55 y, 13.3% vs ≥55 y, 7.8%; P = .03), and female sex (10% of women vs 7.3% of men; P = .01). Gastric ulcers were detected in 15% of endoscopies performed at any time in the 3 years before cancer diagnosis, and in 64% of endoscopies performed 3 to 6 months before a diagnosis of gastric cancer. CONCLUSIONS: Based on a retrospective analysis of medical records in England, in 8.3% of patients with gastric cancer, their cancer was missed at endoscopy within the 3 previous years. A previous endoscopy detected benign gastric ulcers more frequently than any other lesion in patients who later were diagnosed with gastric cancer.
BACKGROUND & AIMS: Single-center studies have estimated that 4.6% to 25.8% of gastric cancers are missed at endoscopy. We performed a population-based study to make a more precise estimate of factors associated with missed lesions in England. METHODS: We performed a retrospective population-based observational cohort study of 2727 patients diagnosed with gastric cancer from April 2011 through March 2012 in England, using linked records from 3 national data sets. The primary outcome was the proportion of patients who had undergone endoscopy in the 3 to 36 months before a diagnosis of gastric cancer. We determined this proportion for the entire cohort and for subgroups. RESULTS: Of the 2727 patients in the cohort, 8.3% (95% confidence interval, 7.2%-9.3%) underwent endoscopic evaluation in the 3 to 36 months before their diagnosis of gastric cancer. An endoscopy within 3 to 36 months of diagnosis was associated with a diagnosis of early stage cancer (stages 0 or 1, 11.5%; stage 2, 7.9%; stages 3 or 4, 6.9%; P = .01 for stage 0 or 1 vs stage 2 or greater), younger age at diagnosis (<55 y, 13.3% vs ≥55 y, 7.8%; P = .03), and female sex (10% of women vs 7.3% of men; P = .01). Gastric ulcers were detected in 15% of endoscopies performed at any time in the 3 years before cancer diagnosis, and in 64% of endoscopies performed 3 to 6 months before a diagnosis of gastric cancer. CONCLUSIONS: Based on a retrospective analysis of medical records in England, in 8.3% of patients with gastric cancer, their cancer was missed at endoscopy within the 3 previous years. A previous endoscopy detected benign gastric ulcers more frequently than any other lesion in patients who later were diagnosed with gastric cancer.
Authors: Jin Hwa Park; Kang Nyeong Lee; Hang Lak Lee; Dae Won Jun; Jai Hoon Yoon; Oh Young Lee; Byung Chul Yoon; Ho Soon Choi Journal: Turk J Gastroenterol Date: 2021-02 Impact factor: 1.852
Authors: Sabina Beg; Krish Ragunath; Andrew Wyman; Matthew Banks; Nigel Trudgill; D Mark Pritchard; Stuart Riley; John Anderson; Helen Griffiths; Pradeep Bhandari; Phillip Kaye; Andrew Veitch Journal: Gut Date: 2017-08-18 Impact factor: 23.059