Yalamarthi, S.; Witherspoon, P.; McCole, D.; Auld, C.D.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA5
Academic Journal
Aim: To determine the incidence and causes for failure in diagnosis of oesophageal and gastric cancer after referral to a surgical endoscopy unit (1994-2001). Methods: Since the introduction of open access endoscopy in 1994, over 13 000 patients have been entered into a prospective database. From a consecutive series of oesophageal and gastric cancer (n = 305), the number of patients undergoing an endoscopy within 3 years of diagnosis were identified and the reasons for missed diagnosis documented. Results: Thirty patients (9.89%) had a minimum of one endoscopy within 3 years of which 20 (67%) occurred within 1 year. Of those patients with a definite missed diagnosis (n = 22), the causes are outlined in the Table. In oesophageal cancer (n = 16), the initial diagnosis was oesophagitis or benign stricture in 56%. In gastric cancer (n = 14), the initial diagnosis of gastritis, ulcer, or suspicious lesion was made in 71.4%. In the overall group, > 4 biopsies were taken in 23% at initial endoscopy with 63% at final endoscopy (p = 0.002). Conclusion: This study emphasises the mportance of detecting cancer at an early stage with a Iow thresho d for multiple b opsies of an abnormal.


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