What Is Appropriate Upper Endoscopic Interval Among Dyspeptic Patients With Previously Normal Endoscopy? A...

Area of Science:

• Gastroenterology
• Clinical Endoscopy
• Medical Statistics

Background:

• The optimal follow-up endoscopy interval for dyspeptic patients with initially normal findings remains uncertain.
• This study addresses the need for evidence-based recommendations on repeat upper endoscopy timing.

Purpose of the Study:

• To determine the appropriate interval for follow-up endoscopy in dyspeptic patients without abnormal findings on prior examinations.
• To identify a change point for the increased frequency of upper gastrointestinal neoplastic lesions.

Main Methods:

• A multicenter analysis of upper endoscopy data from 1595 Korean patients undergoing 2 or more procedures between 2012-2017.
• Bayesian regression with a Metropolis-Hastings algorithm was used to estimate the change point (CP) for neoplasia detection.
• Patients with an endoscopic interval between 90 and 760 days were included, with the first two sessions analyzed.

Main Results:

• Neoplasia was detected in 0.75% (12/1595) of patients on follow-up endoscopy, including 4 gastric cancers and 8 gastric adenomas.
• The estimated change point for an increased frequency of organic lesions was 560 days (95% credible interval: 139-724 days).
• The estimated average frequency of dysplastic lesions increased approximately 4.4-fold after the identified change point.

Conclusions:

• A 2-year interval for repeat upper endoscopy is a reasonable recommendation for dyspeptic patients with previously normal findings.
• This interval aids in the detection of dysplastic lesions and early-stage gastrointestinal cancers.
• The findings support evidence-based guidelines for surveillance endoscopy in this patient population.