The two week WAIT (2WW) referral for upper gastrointestinal cancer: predictors and prevalence of non-upper gastrointestinal cancers in those with negative gastroscopy

Wireko, Matthew; Subramanian, Vishnu; Ragunath, Krish

doi:10.1136/gut.2011.239301.93

Cited by 5 publications

(3 citation statements)

References 1 publication

(1 reference statement)

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“…1 General Surgery; 2 Gastroenterology, University Hospital North Tees, Stockton-on-Tees, UK Introduction For patients referred with suspected upper gastrointestinal (UGI) cancer under the 2 week-wait (2WW), it has been shown that 10.5% will have endoscopic evidence of malignancy, whilst 6.5% of patients may harbour malignancy elsewhere. 1 For those patients with weight loss, a negative gastroscopy for cancer poses an important clinical question for the endoscopist. There are no consensus guidelines advising the most appropriate 'next-step' the endoscopist should make following patients referred with weight loss but have a negative endoscopy for malignancy.…”

Section: What Do Endoscopists Do When No Cancer Is Found On Gastroscomentioning

confidence: 99%

PTH-049 Sub-Optimal Bowel Preparation in the Surveillance Population - what Does it Mean?: Abstract PTH-049 Table 1

Mead

Lim

Cameron

2013

Gut

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PTH-047 Introduction UK practise in diagnostic oesophago-gastric-duodenoscopy (OGD) has changed little over the last 10-20 years. Currently the only quality measure relates to ability to reach the second part of the duodenum. Evidence-based quality indicators in colonoscopy pertain to the quality of views, the amount of time spent examining the mucosa and expected levels of lesion detection, in addition to completion rates. Their adoption, in combination with robust clinical governance has undoubtedly improved the detection of colorectal diseases, patient safety and patient experience. The equivalent evidence base for diagnostic OGD does not exist and this has limited development. Benchmarking is a process measuring the practise of one organisation against its peers and may provide a basis for developing quality standards for upper GI practise. This study measures routine OGD practise in the UK and practise in a Japanese centre of excellence for endoscopy and oesophago-gastric cancers. Methods Two experienced endoscopists recorded OGD practise in the National Cancer Centre Hospital in Tokyo. The following were recorded: net procedural time spent screening the oesophagus, stomach, and duodenum; lens cleaning, mucosa cleaning, presence of residual food; use of dye spray and narrow band imaging; picture numbers and biopsies; patient age and sex.One experienced endoscopist recorded OGD practise during routine diagnostic lists at 3 hospitals. Results 134 procedures were recorded, 67 in each country. The average age in the UK was 58.5 yrs (60% male) and 68.2 yrs in Japan (57% male). The average screening time in Japan was 6:51 mins, and 5:49 mins in the UK. The Japanese use advanced imaging techniques 73% of the time. They were never used in routine UK practise.Japanese endoscopists met weekly reviewing all pathology detected and discussing therapeutic cases. All images were reviewed closely and were an essential part of decision making and education in the unit.

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Section: What Do Endoscopists Do When No Cancer Is Found On Gastroscomentioning

confidence: 99%

PTH-049 Sub-Optimal Bowel Preparation in the Surveillance Population - what Does it Mean?: Abstract PTH-049 Table 1

Mead

Lim

Cameron

2013

Gut

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“…doi:10.1136/gutjnl-2013-304907.537 1,* R Thomas, 1 K Carney, 1 W S Ngu, 1 J Ljevar, 2 D Dwarakanarth, 1 A Agarwal. 1…”

Section: What Do Endoscopists Do When No Cancer Is Found On Gastroscomentioning

confidence: 99%

“…Introduction For patients referred with suspected upper gastrointestinal (UGI) cancer under the 2 week-wait (2WW), it has been shown that 10.5% will have endoscopic evidence of malignancy, whilst 6.5% of patients may harbour malignancy elsewhere. 1 For those patients with weight loss, a negative gastroscopy for cancer poses an important clinical question for the endoscopist. There are no consensus guidelines advising the most appropriate 'next-step' the endoscopist should make following patients referred with weight loss but have a negative endoscopy for malignancy.…”

Section: General Surgery; 2 Gastroenterology University Hospital Normentioning

confidence: 99%

PTH-050 What do Endoscopists do When no Cancer is Found on Gastroscopy Done Following an Upper Gastrointestinal two Week-Wait Referral with Weight Loss?

Thomas¹,

Carney²,

Ngu³

et al. 2013

Gut

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PTH-049 Table 1 Bowel preparation Unsatisfactory Sub-optimal Satisfactory Conclusion 15% of procedures in our surveillance population have sub-optimal or un-satisfactory bowel preparation, making the interpretation of the clinical guidelines difficult.Patients who have sub-optimal or unsatisfactory preparation have a high proportion of further sub-optimal or unsatisfactory procedures. Endoscopy units should have a strategy for improving this.In patients with sub-optimal or unsatisfactory bowel preparation there is a significant reduction in overall polyp detection which is particularly marked in the right colon. This does not appear to be the case with larger polyps.In patients with sub-optimal or unsatisfactory preparation undergoing a complete colonoscopy, shorter surveillance intervals should be considered taking other patient related factors into account.

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Symptoms and signs of upper gastrointestinal disease

Saunders¹,

Edwards²

2015

Medicine

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The two week WAIT (2WW) referral for upper gastrointestinal cancer: predictors and prevalence of non-upper gastrointestinal cancers in those with negative gastroscopy

Cited by 5 publications

References 1 publication

PTH-049 Sub-Optimal Bowel Preparation in the Surveillance Population - what Does it Mean?: Abstract PTH-049 Table 1

PTH-049 Sub-Optimal Bowel Preparation in the Surveillance Population - what Does it Mean?: Abstract PTH-049 Table 1

PTH-050 What do Endoscopists do When no Cancer is Found on Gastroscopy Done Following an Upper Gastrointestinal two Week-Wait Referral with Weight Loss?

Symptoms and signs of upper gastrointestinal disease

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