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Appropriateness of indications for diagnostic upper gastrointestinal endoscopy in India

B Sumathi1, U Navaneethan, V Jayanthi

  • 1Department of Gastroenterology, Institute of Child Health and Hospital for Children, Chennai 600008, Tamil Nadu, India.

Singapore Medical Journal
|January 6, 2009
PubMed

Insights

This study determined optimal age cut-offs for upper gastrointestinal endoscopy in Indian patients with dyspepsia. The findings help guide appropriate use of endoscopy for detecting malignancy in this population.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Oncology

Background:

  • Existing upper gastrointestinal endoscopy guidelines are Western-centric.
  • There is a need for India-specific guidelines for dyspepsia management.
  • This study addresses the lack of data for the Indian population.

Purpose of the Study:

  • To assess the appropriateness of upper gastrointestinal endoscopy for Indian patients with dyspepsia.
  • To identify optimal age cut-offs for endoscopy in detecting upper gastrointestinal malignancy in India.
  • To provide an Indian perspective on endoscopy guidelines.

Main Methods:

  • Prospective study of 3,432 patients undergoing upper digestive endoscopy in India (Jan 2004-June 2005).
  • Included patients with dyspepsia and those with isolated alarm symptoms.
  • Utilized receiver operator characteristic curve analysis to determine age cut-offs for malignancy detection.

Main Results:

  • The study included 2,068 men and 1,364 women with a mean age of 41.6 years.
  • 18.3% of 284 malignancy cases were in the 25-45 age group.
  • Optimal cut-off ages for malignancy detection were 38 years for females and 43.5 years for males.

Conclusions:

  • Endoscopy in South Indian patients with dyspepsia revealed a higher prevalence of normal or benign findings.
  • Specific age cut-offs for upper gastrointestinal malignancy detection were established for both genders in the Indian population.
  • These findings aid in refining endoscopy referral criteria for dyspeptic patients in India.
Abstract

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