Sensitivity of Upper Endoscopy in Diagnosing Esophageal Cancer

Bloomfeld, Richard S.; Bridgers, David; Pineau, Benoit C.

doi:10.1007/s00455-005-0025-x

Cited by 20 publications

(13 citation statements)

References 10 publications

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“…[3][4][5][6][7][8][9][10] A meta-analysis from 2014 confirms these findings. 11 This result is comparable to post-colonoscopy colorectal cancer rates of 2.5-7.7% in Western populations.…”

Section: Introductionsupporting

confidence: 72%

Optimizing early upper gastrointestinal cancer detection at endoscopy

Veitch

Uedo

Yao

et al. 2015

Nat Rev Gastroenterol Hepatol

104

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Survival rates for upper gastrointestinal cancers are poor and oesophageal cancer incidence is increasing. Upper gastrointestinal cancer is also often missed during examinations; a predicament that has not yet been sufficiently addressed. Improvements in the detection of premalignant lesions, early oesophageal and gastric cancers will enable organ-preserving endoscopic therapy, potentially reducing the number of advanced upper gastrointestinal cancers and resulting in improved prognosis. Japan is a world leader in high-quality diagnostic upper gastrointestinal endoscopy and the clinical routine in this country differs substantially from Western practice. In this Perspectives article, we review lessons learnt from Japanese gastroscopy technique, training and screening for risk stratification. We suggest a key performance indicator for upper gastrointestinal endoscopy with a minimum total procedure time of 8 min, and examine how quality assurance concepts in bowel cancer screening in the UK could be applied to upper gastrointestinal endoscopy and improve clinical practice.

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“…[3][4][5][6][7][8][9][10] A meta-analysis from 2014 confirms these findings. 11 This result is comparable to post-colonoscopy colorectal cancer rates of 2.5-7.7% in Western populations.…”

Section: Introductionsupporting

confidence: 72%

Optimizing early upper gastrointestinal cancer detection at endoscopy

Veitch

Uedo

Yao

et al. 2015

Nat Rev Gastroenterol Hepatol

104

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“…In patients with esophageal cancer, tumor location was classified as follows according to Bloomfeld et al. 8 : (i) upper third tumors, from upper esophageal sphincter to 26 cm from incisors, (ii) middle third, 27–33 cm from incisors, and (iii) lower third, 34 cm from incisors to the gastroesophageal junction. In patients with benign or malignant strictures, Savary‐Gilliard dilators (Wilson‐Cook Medical Inc., Winston‐Salem, NC) were used for dilation.…”

Section: Methodsmentioning

confidence: 99%

Use of endoscopy in diagnosis and management of patients with dysphagia in an African setting

Mudawi¹,

Mahmoud²,

Tahir³

et al. 2010

Diseases of the Esophagus

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The objectives of this study were to define the utility of esophagogastroduodenoscopy in the diagnosis and management of patients presenting with dysphagia and to determine the relative incidence of the various causes of dysphagia in Sudan. This is a prospective, cross-sectional, descriptive, hospital-based study carried out at the endoscopy unit of Soba University Hospital, Khartoum, Sudan. All patients complaining of dysphagia underwent upper gastrointestinal endoscopy with therapeutic intervention when necessary. A total of 114 patients were enrolled in the study, with a mean age of 47 years SD +/- 19 and a male to female ratio of 1 : 1.04. A benign condition was diagnosed in 56% of the cases; this included esophageal strictures in 21% of the cases and achalasia in 14%. Malignant causes were mainly due to esophageal cancer (40.4%) and cancer of the stomach cardia (3.5%). Therapeutic intervention was attempted in 83% of the cases. Risk factors predictive of a malignant etiology were age over 40 years (P < 0.000), dysphagia lasting between 1 month and 1 year (P < 0.000), and weight loss (P < 0.000). A barium study was performed in 35 cases (31%) prior to endoscopic examination and proved to be inaccurate in three cases (8.6%). Upper gastrointestinal endoscopy in our African setting is an accurate and useful investigation in the diagnosis and management of patients presenting with dysphagia. Patients over the age of 40 years presenting with dysphagia and weight loss are more likely to have a neoplastic disease and should be referred for urgent endoscopy.

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“…The miss rate for esophageal and gastric cancer at upper gastrointestinal endoscopy is well document, with studies reporting rates of 4 % to 13 % at index endoscopy for cancers diagnosed on subsequent investigations, including repeat endoscopy 1 2 3 4 5 6. …”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial of pre-procedure simethicone and N-acetylcysteine to improve mucosal visibility during gastroscopy – NICEVIS

et al. 2016

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Background and study aims: Mucosal views can be impaired by residual bubbles and mucus during gastroscopy. This study aimed to determine whether a pre-gastroscopy drink containing simethicone and N-acetylcysteine improves mucosal visualisation. Patients and methods: We conducted a randomized controlled trial recruiting 126 subjects undergoing routine gastroscopy. Subjects were randomized 1:1:1 to receive: A—pre-procedure drink of water, simethicone and N-acetylcysteine (NAC); B—water alone; or C—no preparation. Study endoscopists were blinded to group allocation. Digital images were taken at 4 locations (lower esophagus/upper gastric body/antrum/fundus), and rated for mucosal visibility (MV) using a 4-point scale (1 = best, 4 = worst) by 4 separate experienced endoscopists. The primary outcome measure was mean mucosal visibility score (MVS). Secondary outcome measures were procedure duration and volume of fluid flush required to achieve adequate mucosal views. Results: Mean MVS for Group A was significantly better than for Group B (1.35 vs 2.11, P < 0.001) and Group C (1.35 vs 2.21, P < 0.001).Mean flush volume required to achieve adequate mucosal views was significantly lower in Group A than Group B (2.0 mL vs 31.5 mL, P = 0.001) and Group C (2.0 mL vs 39.2 mL P < 0.001). Procedure duration did not differ significantly between any of the 3 groups.MV scores at each of the 4 locations demonstrated significantly better mucosal visibility in Group A compared to Group B and Group C (P < 0.0025 for all comparisons). Conclusions: A pre-procedure drink containing simethicone and NAC significantly improves mucosal visibility during gastroscopy and reduces the need for flushes during the procedure. Effectiveness in the lower esophagus demonstrates potential benefit in Barrett’s oesophagus surveillance gastroscopy.

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Sensitivity of Upper Endoscopy in Diagnosing Esophageal Cancer

Cited by 20 publications

References 10 publications

Optimizing early upper gastrointestinal cancer detection at endoscopy

Optimizing early upper gastrointestinal cancer detection at endoscopy

Use of endoscopy in diagnosis and management of patients with dysphagia in an African setting

A randomized controlled trial of pre-procedure simethicone and N-acetylcysteine to improve mucosal visibility during gastroscopy – NICEVIS

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