Factors Associated with Upper Gastrointestinal Cancer Occurrence After Endoscopy that Did Not Diagnose Cancer.
Dig Dis Sci
; 61(9): 2674-84, 2016 09.
Article
em En
| MEDLINE
| ID: mdl-27129486
ABSTRACT
BACKGROUND AND AIMS:
Up to 14 % of upper gastrointestinal cancer (UGIC) subjects underwent esophago-gastro-duodenoscopy (EGD) in the preceding 3 years, which did not detect UGIC. The frequency of such events and associated risk factors was evaluated.METHODS:
UGIC subjects were identified from a UK primary care database. Post-EGD upper gastrointestinal cancers (PEUGIC) cases were subjects undergoing EGD 12-36 months prior to UGIC diagnosis. Controls had not undergone EGD during the same period. Logistic regression analysis examined associations with PEUGIC.RESULTS:
4249 gastric cancer (GC) subjects (44.8 %) and 5238 esophageal cancer (EC) subjects (55.2 %) were analyzed. There were 633 (6.7 %) PEUGIC subjects [279 EC and 354 GC]. Multivariate analysis revealed that younger age [OR 1.02, (95 % CI 1.01-1.03), p < 0.0001], female gender [1.39 (1.17-1.64), p < 0.0001], increasing comorbidity [1.35 (1.13-1.61), p < 0.0001], and greater deprivation [1.31 (1.09-1.59), p = 0.005] were associated with PEUGIC. Alarm symptoms on presentation [0.32 (0.26-0.40), p < 0.0001] were less likely to be associated with PEUGIC. GC was more likely to be associated with PEUGIC than EC [1.33 (1.13-1.58), p = 0.001]. PEUGIC EGDs reported findings associated with UGIC (stricture or ulceration) in 8.3 % of cases, and only 60.9 % had a follow-up EGD within 90 days. PEUGIC rate declined from 7.9 to 2.7 % for EC and 9.0-6.5 % for GC during the study period.CONCLUSIONS:
PEUGIC occurs in 6.7 % of UGIC. PEUGIC was associated with GC, younger age, female gender, increasing comorbidity and deprivation, and a lack of alarm symptoms.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Classe Social
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Neoplasias Gástricas
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Neoplasias Esofágicas
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Endoscopia do Sistema Digestório
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Erros de Diagnóstico
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
/
Screening_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article