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The optimal endoscopic screening interval for detecting early gastric neoplasms - 16/07/14

Doi : 10.1016/j.gie.2014.01.030 
Chan Hyuk Park, MD 1, Eun Hye Kim, MD 1, Hyunsoo Chung, MD 1, Hyuk Lee, MD 1, Jun Chul Park, MD 1, Sung Kwan Shin, MD 1, Yong Chan Lee, MD, PhD 1, Ji Yeong An, MD, PhD 2, Hyoung-Il Kim, MD 2, Jae-Ho Cheong, MD, PhD 2, Woo Jin Hyung, MD, PhD 2, Sung Hoon Noh, MD, PhD 2, Choong Bae Kim, MD, PhD 2, Sang Kil Lee, MD, PhD 1,
1 Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea 
2 Department of Surgery, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea 

Reprint requests: Sang Kil Lee, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.

Abstract

Background

The optimal interval between endoscopic examinations for detecting early gastric neoplasms, including gastric adenomas, has not previously been studied.

Objective

To clarify the optimal interval between endoscopic examinations for the early diagnosis of both gastric cancers and adenomas.

Design

Retrospective study.

Setting

University-affiliated tertiary-care hospital, Seoul, Korea.

Patients

Patients who were treated for gastric neoplasms between January 2008 and August 2013.

Interventions

Questionnaire survey for interval between the penultimate endoscopy and diagnosis of a gastric neoplasm. A total of 846 patients were divided into 5 groups according to the interval between endoscopic examinations.

Main Outcome Measurements

The proportion of gastric neoplasms treated with endoscopic submucosal dissection and the proportion of advanced gastric cancers according to the interval between endoscopic examinations.

Results

In total, 197, 430, and 219 patients were diagnosed with gastric adenoma, early gastric cancer, and advanced gastric cancer, respectively. In multivariate analysis, the proportion of gastric neoplasms treated with endoscopic submucosal dissection was significantly higher in the ≤12 months, 12 to 24 months, and 24 to 36 months endoscopy interval groups than in the no endoscopy within 5 years group (all P < .001). In addition, the proportion of advanced gastric cancers was significantly lower in the ≤12 months and 12 to 24 months endoscopy interval groups than in the no endoscopy within 5 years group (all P < .001).

Limitations

Retrospective study and recall bias.

Conclusion

Annual endoscopy cannot facilitate the detection of endoscopically treatable gastric neoplasms compared with biennial or triennial endoscopy. We recommend biennial endoscopic screening for gastric neoplasms in order to increase the proportion of lesions discovered while they are still endoscopically treatable and to reduce the number of lesions that progress to advanced gastric cancer.

Il testo completo di questo articolo è disponibile in PDF.

Abbreviations : AGC, EGC, ESD


Mappa


 If you would like to chat with an author of this article, you may contact Dr Lee at sklee@yuhs.ac.
 DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
 See CME section; p. 311.


© 2014  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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