Prevalence and characteristics of post-gastroscopy gastric cancer: A retrospective study from an academic medical center |
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| Affiliation: | 1. Division of Gastroenterology, American University of Beirut Medical Center, P.O. Box 11-0236/16-B, Beirut, Lebanon;2. Department of Pathology & Laboratory Medicine, American University of Beirut Medical Center, PO Box 11-0236, Riad El Solh 11072020, Beirut, Lebanon;1. Endemic Medicine Department, Cairo University Hospitals, Cairo, Egypt;2. Kasr Al-Aini HIV and Viral Hepatitis Fighting Group, Cairo University Hospitals, Cairo, Egypt;3. Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa;4. Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut, Egypt;5. Hepatology Department, Mustapha Bacha Hospital, University of Algiers, Algeria;6. St. Paul''s Hospital Millennium Medical College, Addis Ababa, Ethiopia;1. Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan;2. Department of Endoscopy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, Japan;1. Institute of Gastrosciences and Liver, Apollo Gleneagles Hospitals, Kolkata, India;2. Department of Clinical Imaging and Interventional Radiology, Apollo Gleneagles Hospitals, Kolkata, India;1. Tanta University, Faculty of Medicine, 24 Osman Mohamed St, Tanta, Gharbia 31111, Egypt;2. Tanta University, Faculty of Medicine, Alguish St, Tanta, Gharbia 31111, Egypt;3. St Joseph College, 245 Clinton Ave, Brooklyn, NY 11205, United States;4. UIC College of Medicine, 909 S Wolcott Ave, Chicago, IL 60602, United States;1. Microbiology and Immunology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt;2. Endemic Medicine and Hepatogastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt;3. Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt |
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| Abstract: | Background and Study AimsGastric cancer is diagnosed by endoscopy but false negative rates of up to 10% in the west and 40% in Asia have been reported. In Lebanon, little is known about the rates of post-gastroscopy gastric cancer (PGGC), defined as the proportion of patients diagnosed with gastric cancer with a negative previous examination within 2 years of diagnosis. We aimed to examine the rate of PGGC and its risk factors, clinico-pathologic and endoscopic characteristics at a University medical Center.Patients and MethodsRetrospective analysis of patients with histologically proven gastric malignancy over the last 14 years. Patients with history of upper endoscopy preceding the index diagnostic endoscopy by 6 to 24 months were included.Results18,976 patients underwent upper endoscopy and gastric cancer was diagnosed in 323 (1.7%). Of those, only 4 (1.2%) had a preceding endoscopy within 6 to 24 months of diagnosis: 3 adenocarcinoma and one MALT lymphoma. Upon review of the initial endoscopy, a mucosal abnormality had been noted in all 4 patients and biopsies taken in 3 were negative for cancer. The mean time to cancer diagnosis was 8 months (range 6–13 months).ConclusionA small proportion of gastric carcinomas are missed on endoscopy in this study. Patients with endoscopic evidence of mucosal abnormalities and negative biopsies should undergo repeat examination with multiple biopsies. Proper endoscopic technique, lesion recognition and adoption of performance improvement measures are important to optimize endoscopic practice. |
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| Keywords: | Adenocarcinoma Lymphoma Endoscopy Interval cancer |
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