Download PDF
CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(10): E1333-E1342
DOI: 10.1055/a-1922-6429
Original article

Assigning a different endoscopist for each annual follow-up may contribute to improved gastric cancer detection rates

Shuhei Unno
1   Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
2   Department of Gastroenterology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
,
Kimihiro Igarashi
1   Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
,
Hiroaki Saito
1   Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
,
Dai Hirasawa
1   Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
,
Toru Okuzono
1   Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
,
Yukari Tanaka
1   Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
,
Masato Nakahori
1   Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
,
Tomoki Matsuda
1   Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background and study aims Esophagogastroduodenoscopy (EGD) is an effective and important diagnostic tool to detect gastric cancer (GC). Although previous studies show that examiner, patient, and instrumental factors influence the detection of GC, we analyzed whether assigning a different examiner to surveillance EGD would improve the detection of GC compared to assigning the same examiner as in the previous endoscopy.

Patients and methods We retrospectively reviewed patients who underwent two or more consecutive surveillance EGDs at a single center between 2017 and 2019. We identified factors associated with GC detection using multivariable regression analysis and propensity-score matching.

Results Among 7794 patients, 99 GC lesions in 93 patients were detected by surveillance EGD (detection rate; 1.2 %), with a mean surveillance interval of 11.2 months. Among the detected 99 lesions, 87 (87.9 %) were curatively treated with endoscopy. There were no differences in the clinicopathologic characteristics of GC detected by the same or different endoscopists. GC detection in the group examined by different endoscopists was more statistically significant than in the group examined by the same endoscopist, even after propensity-score matching (1.6 % and 0.7 %; P < 0.05). Endoscopic experience and other factors were not statistically significant between the two groups.

Conclusions In surveillance EGD, having a different endoscopist for each exam may improve GC detection rates, regardless of the endoscopist’s experience.



Publication History

Received: 21 January 2022

Accepted after revision: 03 August 2022

Article published online:
17 October 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2022; 54(11): 1127-1127
DOI: 10.1055/a-1884-3235

 

  • References

  • 1 Sung H, Ferlay J, Siegel RL. et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71: 209-249
    Google Scholar
  • 2 Jun JK, Choi KS, Lee HY. et al. Effectiveness of the Korean National Cancer Screening Program in reducing gastric cancer mortality. Gastroenterology 2017; 152: 1319-1328.e7
    CrossrefPubMedGoogle Scholar
  • 3 Hamashima C, Ogoshi K, Narisawa R. et al. Impact of endoscopic screening on mortality reduction from gastric cancer. World J Gastroenterol 2015; 21: 2460-2466
    CrossrefPubMedGoogle Scholar
  • 4 Matsumoto S, Yoshida Y. Efficacy of endoscopic screening in an isolated island: A case-control study. Indian J Gastroenterol 2014; 33: 46-49
    CrossrefPubMedGoogle Scholar
  • 5 Tsukuma H, Oshima A, Narahara H. et al. Natural history of early gastric cancer: a non-concurrent, long term, follow up study. Gut 2000; 47: 618-621
    Google Scholar
  • 6 Ezoe Y, Muto M, Uedo N. et al. Magnifying narrowband imaging is more accurate than conventional white-light imaging in diagnosis of gastric mucosal cancer. Gastroenterology 2011; 141: 2017-2025
    CrossrefPubMedGoogle Scholar
  • 7 Nakajima T, Oda I, Gotoda T. et al. Metachronus gastric cancers after endoscopic resection: How effective is annual endoscopic surveillance?. Gastric Cancer 2006; 9: 93-98
    CrossrefPubMedGoogle Scholar
  • 8 Abe S, Oda I, Suzuki H. et al. Long-term surveillance and treatment outcomes of metachronous gastric cancer occurring after curative endoscopic submucosal dissection. Endoscopy 2015; 47: 1113-1118
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Hernanz N, Rodríguez de Santiago E, Marcos Prieto HM. et al. Characteristics and consequences of missed gastric cancer: A multicentric cohort study. Dig Liver Dis 2019; 51: 894-900
    CrossrefPubMedGoogle Scholar
  • 10 Pimenta-Melo AR, Monteiro-Soares M, Libânio D. et al. Missing rate for gastric cancer during upper gastrointestinal endoscopy: A systematic review and meta-Analysis. Eur J Gastroenterol Hepatol 2016; 28: 1041-1049
    CrossrefPubMedGoogle Scholar
  • 11 Menon S, Trudgill N. How commonly is upper gastrointestinal cancer missed at endoscopy? A meta-analysis. Endosc Int Open 2014; 02: E46-E50
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Hosokawa O, Hattori MDK. et al. Difference in accuracy between gastroscopy and colonoscopy for detection of cancer. Hepatogastroenterology 2007; 54: 442-444
    PubMedGoogle Scholar
  • 13 Yao K. The endoscopic diagnosis of early gastric cancer. Ann Gastroenterol 2013; 26: 11-22
    PubMedGoogle Scholar
  • 14 Kawamura T, Wada H, Sakiyama N. et al. Examination time as a quality indicator of screening upper gastrointestinal endoscopy for asymptomatic examinees. Dig Endosc 2017; 29: 569-575
    CrossrefPubMedGoogle Scholar
  • 15 Zhang Q, Chen ZY, Chen di C. et al. Training in early gastric cancer diagnosis improves the detection rate of early gastric cancer: An observational study in China. Medicine (United States) 2015; 94: e384
    PubMedGoogle Scholar
  • 16 Yamazato T, Oyama T, Yoshida T. et al. Two years’ intensive training in endoscopic diagnosis facilitates detection of early gastric cancer. Intern Med 2012; 51: 1461-1465
    CrossrefPubMedGoogle Scholar
  • 17 Barnett ML, Boddupalli D, Nundy S. et al. Comparative accuracy of diagnosis by collective intelligence of multiple physicians vs individual physicians. JAMA Netw Open 2019; 2: e190096
    CrossrefPubMedGoogle Scholar
  • 18 Aslanian HR, Shieh FK, Chan FW. et al. Nurse observation during colonoscopy increases polyp detection: A randomized prospective study. Am J Gastroenterol 2013; 108: 166-172
    CrossrefPubMedGoogle Scholar
  • 19 Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy 1969; 1: 87-97
    Google Scholar
  • 20 Sano T, Kodera Y. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 2011; 14: 101-112
    CrossrefPubMedGoogle Scholar
  • 21 Lambert RLC. The Paris Endoscopic Classification of Superficial neoplastic lesions. Gastrointest Endosc 2003; 58: 3-43
    CrossrefPubMedGoogle Scholar
  • 22 Komatsu S, Otsuji E. Essential updates 2017/2018: Recent topics in the treatment and research of gastric cancer in Japan. Ann Gastroenterol Surg 2019; 3: 581-591
    CrossrefPubMedGoogle Scholar
  • 23 Sugimoto M, Murata M, Yamaoka Y. Chemoprevention of gastric cancer development after Helicobacter pylori eradication therapy in an East Asian population, Meta-analysis. World J Gastroenterol 2020; 21: 1820-1840
    CrossrefPubMedGoogle Scholar
  • 24 Kitamura Y, Ito M, Matsuo T. et al. Characteristic epithelium with low-grade atypia appears on the surface of gastric cancer after successful Helicobacter pylori eradication therapy. Helicobacter 2014; 19: 289-295
    CrossrefPubMedGoogle Scholar
  • 25 Delgado GPG, Morales AVJ, Jimeno RM. et al. Gastric cancer missed at esophagogastroduodenoscopy in a well-defined Spanish population. Dig Liver Dis 2019; 51: 1123-1129
    CrossrefPubMedGoogle Scholar
  • 26 Park MS, Yoon JY, Chung HS. et al. Clinicopathologic characteristics of interval gastric cancer in Korea. Gut Liver 2015; 9: 167-173
    PubMedGoogle Scholar
  • 27 Jin S, Jeon SW, Kwon Y. et al. Optimal endoscopic screening interval for early detection of gastric cancer: a single-center study. J Korean Med Sci 2018; 33: 1-10.e166
    PubMedGoogle Scholar
  • 28 Abe S, Oda I, Minagawa T. et al. Metachronous gastric cancer following curative endoscopic resection of early gastric cancer. Clin Endosc 2018; 51: 253-259
    CrossrefPubMedGoogle Scholar
  • 29 Park JM, Huo SM, Lee HH. et al. Longer observation time increases proportion of neoplasms detected by esophagogastroduodenoscopy. Gastroenterology 2017; 153: 460-469.e1
    CrossrefPubMedGoogle Scholar
  • 30 Asaka M, Kato M, Takahashi SI. et al. Guidelines for the management of helicobacter pylori infection in Japan: 2009 revised edition. Helicobacter 2010; 15: 1-20
    CrossrefPubMedGoogle Scholar
  • 31 Kumar NL, Smith BN, Lee LS. et al. Best practices in teaching endoscopy based on a delphi survey of gastroenterology program directors and experts in endoscopy education. Clin Gastroenterol Hepatol 2020; 18: 574-579.e1
    CrossrefPubMedGoogle Scholar
  • 32 Kamada T, Haruma K, Ito M. et al. Time trends in Helicobacter pylori infection and atrophic gastritis over 40 years in Japan. Helicobacter 2015; 20: 192-198
    CrossrefPubMedGoogle Scholar
  • 33 Ladeiras-Lopes R, Pereira AK, Nogueira A. et al. Smoking and gastric cancer: Systematic review and meta-analysis of cohort studies. Cancer Causes Control 2008; 19: 689-701
    CrossrefPubMedGoogle Scholar
  • 34 Yaghoobi M, Bijarchi R, Narod SA. Family history and the risk of gastric cancer. Br J Cancer 2010; 102: 237-242
    CrossrefPubMedGoogle Scholar
  • 35 Dixon MF, Genta RM, Yardley JH CP. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996; 20: 1161-1181
    PubMedGoogle Scholar