Missed Esophageal and Gastric Cancers after Esophagogastroduodenoscopy in a Midwestern Military Veteran Population

Abstract

The true incidence of missed EGC in military veteran patients is not known. It is difficult to compare our findings to those of other studies because of the heterogeneity of studies. Our study echoes the findings of the others: EGD remains an important and effective tool in diagnosing EGC. At the same time, it also points out an important limitation, that EGC can be missed on EGD. Our findings also emphasize the importance of obtaining biopsies of any abnormality and timely clinical follow-up and by repeat EGD as needed.

Optimizing early upper gastrointestinal cancer detection at endoscopy

“…[3][4][5][6][7][8][9][10] A meta-analysis from 2014 confirms these findings. 11 This result is comparable to post-colonoscopy colorectal cancer rates of 2.5-7.7% in Western populations.…”

Improving the mucosal visualization at gastroscopy: a systematic review and meta-analysis of randomized, controlled trials reporting the role of Simethicone ± N-acetylcysteine

“…The aforementioned factors are potentially modifiable factors to improve mucosal visualization and avoid missed diagnoses. Various studies have demonstrated the incidence of missed diagnoses on upper gastrointestinal endoscopy and this could be prevented by efforts to improve mucosal visibility (2)(3)(4)(5)(6). Simethicone with or without N-acetyl cysteine (NAC) is one of the most frequently used pre-procedural oral medication to counteract the poor mucosal visibility secondary to froth and bubbles.…”

Factors associated with oesophagogastric cancers missed by gastroscopy: a case–control study

“…It is well recognised that colorectal cancers may be diagnosed shortly after a reportedly normal colonoscopy and a similar situation exists in OG cancer: between 5.3% and 13.9% of patients with OG malignancy in the Western population8–14 have had normal gastroscopies reported within the previous 3 years. Based on studies of cancer biology which suggest that the doubling time of an early gastric cancer is between 2 and 3 years,15 gastroscopy is considered to have definitely missed a cancer if performed in the year before diagnosis and possibly missed a cancer if done within the previous 3 years 10.…”