Factors Associated with Upper Gastrointestinal Cancer Occurrence After Endoscopy that Did Not Diagnose Cancer

Abstract

PEUGIC occurs in 6.7 % of UGIC. PEUGIC was associated with GC, younger age, female gender, increasing comorbidity and deprivation, and a lack of alarm symptoms.

Rate of missed oesophageal cancer at routine endoscopy and survival outcomes: A multicentric cohort study

“…This last association had been detected in previous investigations and may be explained by the partial mucosal healing of small mucosal lesions in the distal third of the oesophagus by PPI therapy 25 , 26 . Female gender, younger age, non‐gastroenterologist endoscopist and increasing comorbidity have also been postulated to increase the likelihood of interval upper gastrointestinal cancer 9 , 10 , 12 . Noticeably, neither our study (20% MEC versus 33% non‐MEC, p = 0.16) nor other investigations have proven that sedation is related to MEC, but some data indicate that moderate sedation increases UGE examination quality and patient satisfaction 27 .…”

“…Other physician‐related factors that have been proposed to explain missed cancers in UGE are not to biopsy benign‐like lesions, the presence of oesophagitis, obtaining an insufficient number of biopsies, pathological errors or follow‐up delay 12 , 13 . This reinforces the idea that every stricture, ulcer or non‐specific oesophageal mucosal abnormality should be biopsied and closely monitored 11 , 28 .…”

“…Fujita et al. suggested a doubling time of 2–3 years for gastric cancer, and most authors have considered an interval time of from 6 months up to 3.5 years 7–9 , 12 , 13 , 15–18 . Cancer within the first 3–6 months of a negative UGE has usually been excluded, because information from administrative databases was not precise enough to determine if these UGE were part of the diagnostic work‐up 11 , 19 .…”

“…Studies addressing missed upper gastrointestinal tumours have also found that 4.6% to 25.8% of patients had a negative endoscopy within 3 years before diagnosis 7 . Nevertheless, the number of studies is limited, and most of them have focused on gastric cancer or adenocarcinoma arising from previously diagnosed Barrett's oesophagus (BE) 7–12 . Missed oesophageal cancer (MEC) is a poorly characterized entity in the non‐BE population with only a few retrospective studies in this area, mainly from the UK and with data coming from administrative databases 11 , 13 .…”

The National Oesophagogastric Cancer Awareness Campaign: a locality outcome analysis from County Durham

“…However, improving current services by means of improving quality of gastroscopy and follow-up clinical care in the endoscopy unit should be a target of improvement. A study by Cheung et al 8 in the UK revealed that the ‘missed’ UGI cancer rate among patients who had a gastroscopy in the preceding 12–36 months was 6.7%. This study also suggests that patients with recurrent reflux symptoms were three times more likely to have a malignancy compared with symptoms such as dysphagia.…”