Screening endoscopy for gastric cancer: time for quality control

Kim, Eun Hye; Park, Chan Hyuk

doi:10.21037/tgh.2017.09.09

Cited by 4 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…22,23 However, the interval of cancer screening has been determined empirically, and there is no clear evidence as to the optimal screening interval. 24 In this study, periodic methylation was observed in consistent with the cyclic stabilization of cancer-prone stem cells every 8 years. A previous gastric cancer screening at 5-year intervals revealed a decrease in the incidence of gastric cancer at the first follow-up and an increase at the second follow-up.…”

supporting

confidence: 71%

Periodic Methylation Patterns in the Background Mucosa of Gastric Cancer

Kim

et al. 2019

Korean J Helicobacter Up Gastrointest Res

View full text Add to dashboard Cite

Background/Aims: Gastrointestinal glandular stem cells renew every 8 years. New stem cells with impeded housekeeping gene methylation have unstable phenotypes and are prone to transform into malignant cells. Age-related changes in methylation in the gastric mucosa were evaluated to define the period of cancer-prone stem cell replacement. Materials and Methods: Endoscopic biopsy specimens of normal-appearing gastric mucosa were obtained from 148 Helicobacter pylori-negative controls, 124 H. pylori-positive controls, and 69 gastric cancer patients with closed-type mucosal atrophy. Methylation-variable sites of two stomach-specific genes (TFF2 and TFF3) and four housekeeping genes (CDH1, ARRDC4, MMP2, and CDKN2A) were analyzed using radioisotope-labeled methylation-specific polymerase chain reaction. Age-related methylation was evaluated depending on the gastric mucosal atrophy at 2-year intervals. Results: TFF2 methylation peaked periodically at 40 to 41, 48 to 49, 56 to 57, and 64 to 65 years of age in H. pylori-negative controls. Periodic peaks of TFF2 methylation were also found in H. pylori-positive controls. Housekeeping-gene methylation troughed at 48 to 49, 56 to 57, and 68 to 69 years of age in cancer patients. Trough methylation of CDH1 and ARRDC4 was lower in cancer patients than in H. pylori-positive controls. Conclusions: Methylation peaks of stomach-specific TFF2 in controls and methylation troughs of housekeeping genes in cancer patients were found every 8 years. Periodic methylation patterns may be used to identify individuals at high risk for gastric cancer.

show abstract

supporting

confidence: 71%

Periodic Methylation Patterns in the Background Mucosa of Gastric Cancer

Kim

et al. 2019

Korean J Helicobacter Up Gastrointest Res

View full text Add to dashboard Cite

show abstract

“…Similar endoscopic biopsy rates (32.6% vs 32.4%, P = 0.945) were observed between the 2 stages, suggesting that increased detectability was not achieved through increased biopsy but might be attributed to increased care of endoscopists or more target biopsies performed. Moreover, the Hawthorne effect ( 24 ), which describes the reactivity in which individuals modify their behaviors in response to their awareness of being observed, might also play a role in the research effect. However, the neoplastic lesion detection rate did not differ significantly between the 2 stages (1.8% vs 2.2%, P = 0.483).…”

Section: Discussionmentioning

confidence: 99%

Setting 6-minute minimal examination time improves the detection of focal upper gastrointestinal tract lesions during endoscopy: a multicenter prospective study

Gao

Cai

Tian

et al. 2023

Clin Transl Gastroenterol

View full text Add to dashboard Cite

INTRODUCTION: Positive correlation between examination time and neoplasm detection using esophagogastroduodenoscopy (EGD) has been described by observational studies, but the effect of setting minimal examination time still requires investigation. METHODS: This prospective, 2-stage, interventional study was conducted in 7 tertiary hospitals in China, enrolling consecutive patients undergoing intravenously sedated diagnostic EGDs. In stage I, the baseline examination time was collected without informing the endoscopists. In stage II, the minimal examination time was set for the same endoscopist according to the median examination time of normal EGDs in stage I. The primary outcome was the focal lesion detection rate (FDR), defined as the proportion of subjects with at least one focal lesion among all subjects. RESULTS: A total of 847 and 1,079 EGDs performed by 21 endoscopists were included in stages I and II, respectively. In stage II, the minimal examination time was set as 6 minutes, and the median time for normal EGD increased from 5.8 to 6.3 minutes (P < 0.001). Between the 2 stages, the FDR was significantly improved (33.6% vs 39.3%, P = 0.011), and the effect of the intervention was significant (odds ratio, 1.25; 95% confidence interval, 1.03–1.52; P = 0.022) even after adjusting for subjects' age, smoking status, endoscopists' baseline examination time, and working experience. The detection rate of high-risk lesions (neoplastic lesions and advanced atrophic gastritis) was also significantly higher in stage II (3.3% vs 5.4%, P = 0.029). In the endoscopist-level analysis, all practitioners reached a median examination time of 6 minutes, and the coefficients of variation of FDR (36.9%–26.2%) and examination time (19.6%–6.9%) decreased in stage II. DISCUSSION: Setting a 6-minute minimal examination time significantly improved the detection of focal lesions during EGDs and has the potential to be implemented for quality improvement.

show abstract

“…Currently, there is no national screening program for GC in Vietnam, and some hospitals designed their own surveillance schedules. Recent studies reported that a surveillance interval of every two years would be ideal to detect GC in the early stages [14,15], but the crucial issue would be the quality of the index EGD endoscopic examination as well as the endoscopist's experience in recognizing [16]. This is an important issue which should be further investigated in future studies.…”

Section: Discussionmentioning

confidence: 99%

Improving Efficacy of Endoscopic Diagnosis of Early Gastric Cancer: Gaps to Overcome from the Real-World Practice in Vietnam

Quach

et al. 2020

BioMed Research International

View full text Add to dashboard Cite

Objective. To identify factors associated with increased proportion of early gastric cancer to total detected gastric cancer among patients undergoing diagnostic esophagogastroduodenoscopy. Methods. A nationwide survey was conducted across 6 central-type and 6 municipal-type Vietnamese hospitals. A questionnaire regarding annual esophagogastroduodenoscopy volume, esophagogastroduodenoscopy preparation, the use of image-enhanced endoscopy, and number of gastric cancer diagnosed in 2018 was sent to each hospital. Results. The total proportion of early gastric cancer was 4.0% (115/2857). Routine preparation with simethicone and the use of image-enhanced endoscopy were associated with higher proportion of early gastric cancer (OR 1.9, 95% CI: 1.1–3.2, p=0.016; OR 2.7, 95% CI: 1.8–4.0, p<0.001, respectively). Esophagogastroduodenoscopies performed at central-type hospitals were associated with higher proportion of early gastric cancer (OR 1.9, 95% CI: 1.1–3.2, p=0.017). Esophagogastroduodenoscopies performed at hospitals with an annual volume of 30.000–60.000 were associated with higher proportion of early gastric cancer than those performed at hospitals with an annual volume of 10.000-<30.000 (OR 2.7, 95% CI: 1.6–4.8, p<0.001) and with a volume of >60.000–100.000 (OR 2.7, 95% CI: 1.7–4.2, p<0.001). Only four (33.3%) hospitals reported all endoscopic types of early gastric cancer. Conclusions. The detection of early gastric cancer is still challenging even for endoscopists working in regions with relatively high prevalence. The real-world evidence showed that endoscopic detection of early gastric cancer could potentially improve with simple adjustments of esophagogastroduodenoscopy protocols.

show abstract

Screening endoscopy for gastric cancer: time for quality control

Cited by 4 publications

References 15 publications

Periodic Methylation Patterns in the Background Mucosa of Gastric Cancer

Periodic Methylation Patterns in the Background Mucosa of Gastric Cancer

Setting 6-minute minimal examination time improves the detection of focal upper gastrointestinal tract lesions during endoscopy: a multicenter prospective study

Improving Efficacy of Endoscopic Diagnosis of Early Gastric Cancer: Gaps to Overcome from the Real-World Practice in Vietnam

Contact Info

Product

Resources

About