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Updated: Oct 12, 2025
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Published on: February 16, 2024
Gastric Cancers Missed at Upper Endoscopy in Central Norway 2007 to 2016-A Population-Based Study
Marianne Beck1, Erling A Bringeland1,2, Gunnar Qvigstad1,3
1Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway.
Background:
The rates of missed gastric cancers (MGC) at upper endoscopy (UE) has been reported at 5-10% in Western countries. We aimed to calculate the rate of MGC and identify factors associated with MGC.
Methods:
Retrospective population-based cohort study including 730 patients diagnosed with gastric adenocarcinoma in Central Norway 2007-2016. MGCs were incident gastric adenocarcinomas diagnosed 6-36 months after a previous UE. Factors associated with MGC were examined. Definitely missed (UE 6-12 months prior) and potentially missed (UE 12-36 months prior) MGCs were compared.
Results:
Sixty-seven (9.2%) of 730 gastric cancers were MGC. MGC were associated with localization (p = 0.009) and more frequent in the corpus, Lauren's histological type (p = 0.028) and diffuse type more prevalent, and previous Billroth 2-operation (14.9% vs. 4.7%, p = 0.001). MGCs were diagnosed at earlier stages (p = 0.037). An ulceration was more common in patients with definitely missed than potentially MGC (40.9% vs. 17.8%, p = 0.041).
Conclusions:
MGC accounted for 9.2% of gastric cancers in Central Norway. MGC were associated with localization in the corpus, Lauren´s diffuse type and previous Billroth-2-operation. Intensified follow-up and adequate biopsy sampling of patients with gastric ulcerations could reduce the rate of missed gastric cancers.
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