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Published on: February 16, 2024
Interval Advanced Gastric Cancer After Negative Endoscopy.
Tae Jun Kim1, Jeung Hui Pyo2, Young Hye Byun2
1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Shorter observation times during esophagogastroduodenoscopy (EGD) predict interval advanced gastric cancer (AGC). Longer withdrawal times may improve screening EGD quality for early gastric cancer detection.
Area of Science:
- Gastroenterology
- Oncology
- Medical Diagnostics
Background:
- Esophagogastroduodenoscopy (EGD) effectively reduces gastric cancer mortality by detecting early-stage disease.
- Interval advanced gastric cancer (AGC) after a negative EGD remains a clinical concern.
- This study investigates predictors of interval AGC following negative EGD.
Purpose of the Study:
- To identify characteristics and predictors of interval advanced gastric cancer (AGC) after a negative esophagogastroduodenoscopy (EGD).
- To compare interval AGC with screen-detected early gastric cancer (EGC) based on clinical and endoscopic factors.
Main Methods:
- A retrospective analysis of 1257 patients diagnosed with gastric cancer within 6-36 months of a negative index EGD.
- Comparison of clinical, endoscopic characteristics, and quality indicators between interval AGC and screen-detected EGC groups.
- Multivariable analysis adjusted for patient demographics, H. pylori status, and endoscopy-related factors.
Main Results:
- 102 interval AGC cases (8.1%) and 1155 EGC cases (91.9%) were identified within 6-36 months post-EGD.
- Shorter observation time (<3 minutes) during the index EGD was significantly higher in the interval AGC group (P=0.002).
- Shorter observation time (<3 minutes) (OR 2.27) and interval time >2 years (OR 1.84) were associated with increased risk of interval AGC.
Conclusions:
- Shorter observation time during index EGD is a significant predictor of interval advanced gastric cancer (AGC).
- Withdrawal times exceeding 3 minutes may serve as a quality indicator for screening EGD to improve early gastric cancer detection.
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