Occurrence and risk factors of missed carcinoma in the upper gastrointestinal tract 2013–2023: retrospective observational study
Jakub Langner1, Ivana Mikoviny Kajzrlíková Orcid.org 1, Petr Vítek2, Barbora Hořavová 3, Martin Chrostek Orcid.org 4
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Summary
Background: Post-endoscopy upper gastrointestinal cancer (PEUGIC) is defined as carcinoma in the upper gastrointestinal (GI) tract, which was preceded by negative upper endoscopy in the past 3 years. According to current knowledge, the rate of PEUGIC is an important parameter of endoscopic quality and should not exceed 10%. The aim of this study was to evaluate the occurrence and risk factors of PEUGIC at a non-university hospital in Frýdek-Místek between 2013 and 2023. Methodology: This is a retrospective analysis of the patients diagnosed with upper GI cancer from January 2013 to December 2023. The data analyzed included family history of upper GI cancer, indications of the examination, therapy, tumor location, and histological type. Risk factors for PEUGIC were calculated using the Chi-squared test and Fisher‘s exact test, with P < 0.05 considered significant. Results: During the study period, a total of 22,727 gastroscopies were performed in total, and 122 patients were diagnosed with upper GI cancer (88 men and 34 women), including 35 esophageal tumors, 80 gastric tumors, and 7 duodenal tumors. Family history of upper GI tumors was reported in 10 patients. PEUGIC was identified in 12 patients (9.84%, 9 men and 3 women, mean age 69.25 years), including 6 in the esophagus, 5 in the stomach, and 1 in the duodenum. Two patients had early detection as part of adequate surveillance (Barrett‘s esophagus, post-polypectomy). Thus, we can evaluate 10 patients as true PEUGIC (8.20%). Tumor location, histology, male gender, or family history of upper GI tumors were not statistically significant risk factors for detecting PEUGIC. Conclusion: The overall rate of PEUGIC at our institution over the 11-year study period was 9.86%, and without early detected lesions as part of adequate surveillance, it was 8.20%. Early detection of PEUGIC indicated poorer endoscopy quality that needs to be distinguished from early detection of carcinoma with adequate surveillance.
Keywords
gastrointestinal neoplasms, esophageal neoplasms, stomach neoplasms, quality indicators, early detection of cancerTo read this article in full, please register for free on this website.
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