Abstract
Background
Quality indicators of screening esophagogastroduodenoscopy are essential to improve the detection rate of gastric cancer. However, a reliable, practical indicator of the performance of endoscopists in screening esophagogastroduodenoscopy has not yet been identified.
Aims
We aimed to identify quality indicators of esophagogastroduodenoscopy for the detection of early gastric neoplasms, including gastric dysplasia and early gastric cancer, focusing on the endoscopic findings.
Methods
The records of 54,889 individuals who underwent esophagogastroduodenoscopy for gastric cancer screening at the Yonsei University Severance Hospital Health Promotion Center, Seoul, Korea, between February 2006 and July 2013 were analyzed. The detection rates for various gastric lesions including early gastric neoplasms were analyzed for each endoscopist.
Results
Gastric dysplasia, early gastric cancer, and advanced gastric cancer were detected in 97 (0.18 %), 54 (0.10 %), and 21 (0.04 %) of 54,889 individuals, respectively. Multivariate analysis showed that the detection rates of gastric subepithelial lesions and gastric diverticuli were independent factors associated with the detection rate of early gastric neoplasms (regression coefficients of 0.096 and 0.532, respectively). A quality score formula was deduced using these regression coefficients to predict the ability of an endoscopist to detect early gastric neoplasms. A trend test confirmed that the group of endoscopists with a higher quality score showed a significantly higher rate of early gastric neoplasm detection (P < 0.001).
Conclusions
The detection rates of gastric subepithelial lesions and gastric diverticuli are well correlated with that of early gastric neoplasms. In addition, the proposed quality scoring system could be a good quality indicator for the detection of early gastric neoplasms.
Similar content being viewed by others
References
Correa P. A human model of gastric carcinogenesis. Cancer Res. 1988;48:3554–3560.
Vieth M, Stolte M. Elevated risk for gastric adenocarcinoma can be predicted from histomorphology. World J Gastroenterol. 2006;12:6109–6114.
Adamu MA, Weck MN, Gao L, et al. Incidence of chronic atrophic gastritis: systematic review and meta-analysis of follow-up studies. Eur J Epidemiol. 2010;25:439–448.
Ohata H, Kitauchi S, Yoshimura N, et al. Progression of chronic atrophic gastritis associated with Helicobacter pylori infection increases risk of gastric cancer. Int J Cancer. 2004;109:138–143.
Miki K. Gastric cancer screening by combined assay for serum anti-Helicobacter pylori IgG antibody and serum pepsinogen levels—“ABC method”. Proc Jpn Acad Ser B Phys Biol Sci. 2011;87:405–414.
Vradelis S, Maynard N, Warren BF, et al. Quality control in upper gastrointestinal endoscopy: detection rates of gastric cancer in Oxford 2005–2008. Postgrad Med J. 2011;87:335–339.
Suh M, Choi KS, Lee YY, et al. Trends in cancer screening rates among Korean men and women: results from the Korean National Cancer Screening Survey, 2004–2012. Cancer Res Treat. 2013;45:86–94.
Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.
Lee HJ, Yang HK, Ahn YO. Gastric cancer in Korea. Gastric Cancer. 2002;5:177–182.
Inoue M, Tsugane S. Epidemiology of gastric cancer in Japan. Postgrad Med J. 2005;81:419–424.
Isobe Y, Nashimoto A, Akazawa K, et al. Gastric cancer treatment in Japan: 2008 annual report of the JGCA nationwide registry. Gastric Cancer. 2011;14:301–316.
Axon A. Symptoms and diagnosis of gastric cancer at early curable stage. Best Pract Res Clin Gastroenterol. 2006;20:697–708.
Nam SY, Choi IJ, Park KW, et al. Effect of repeated endoscopic screening on the incidence and treatment of gastric cancer in health screenees. Eur J Gastroenterol Hepatol. 2009;21:855–860.
Chung SJ, Park MJ, Kang SJ, et al. Effect of annual endoscopic screening on clinicopathologic characteristics and treatment modality of gastric cancer in a high-incidence region of Korea. Int J Cancer. 2012;131:2376–2384.
Cohen J, Safdi MA, Deal SE, et al. Quality indicators for esophagogastroduodenoscopy. Am J Gastroenterol. 2006;101:886–891.
Faigel DO, Pike IM, Baron TH, et al. Quality indicators for gastrointestinal endoscopic procedures: an introduction. Am J Gastroenterol. 2006;101:866–872.
Schlemper RJ, Riddell RH, Kato Y, et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut. 2000;47:251–255.
Iwakiri K, Hayashi Y, Sakamoto C. The diversity of gastric carcinoma. Berlin: Springer; 2005:185–202.
Moons KG, Harrell FE, Steyerberg EW. Should scoring rules be based on odds ratios or regression coefficients? J Clin Epidemiol. 2002;55:1054–1055.
Lochhead P, El-Omar EM. Gastric cancer. Br Med Bull. 2008;85:87–100.
Kaminski MF, Regula J, Kraszewska E, et al. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med. 2010;362:1795–1803.
Barclay RL, Vicari JJ, Doughty AS, et al. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy. N Engl J Med. 2006;355:2533–2541.
Lieberman D, Nadel M, Smith RA, et al. Standardized colonoscopy reporting and data system: report of the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. Gastrointest Endosc. 2007;65:757–766.
Nishida T, Kawai N, Yamaguchi S, et al. Submucosal tumors: comprehensive guide for the diagnosis and therapy of gastrointestinal submucosal tumors. Dig Endosc. 2013;25:479–489.
Rashid F, Aber A, Iftikhar SY. A review on gastric diverticulum. World J Emerg Surg. 2012;7:1.
The Korean Society of Gastrointestinal Endoscopy. Atlas of gastrointestinal endoscopy, 1st ed. London: Medbook Co., Ltd.; 2011.
Oviedo J, Swan N, Farraye FA. Gastric xanthomas. Am J Gastroenterol. 2001;96:3216–3218.
Leung WK, Wu M, Kakugawa Y, et al. Screening for gastric cancer in Asia: current evidence and practice. Lancet Oncol.. 2008;9:279–287.
Crew KD, Neugut AI. Epidemiology of gastric cancer. World J Gastroenterol. 2006;12:354–362.
Dhobi MA, Wani KA, Parray FQ, et al. Gastric cancer in young patients. Int J Surg Oncol.. 2013;2013:981654.
Rugge M, Correa P, Di Mario F, et al. OLGA staging for gastritis: a tutorial. Dig Liver Dis.. 2008;40:650–658.
Capelle LG, de Vries AC, Haringsma J, et al. The staging of gastritis with the OLGA system by using intestinal metaplasia as an accurate alternative for atrophic gastritis. Gastrointest Endosc. 2010;71:1150–1158.
Satoh K, Kimura K, Taniguchi Y, et al. Distribution of inflammation and atrophy in the stomach of Helicobacter pylori-positive and -negative patients with chronic gastritis. Am J Gastroenterol. 1996;91:963–969.
Ito S, Azuma T, Murakita H, et al. Profile of Helicobacter pylori cytotoxin derived from two areas of Japan with different prevalence of atrophic gastritis. Gut. 1996;39:800–806.
Liu Y, Uemura N, Xiao S, et al. Agreement between endoscopic and histological gastric atrophy scores. J Gastroenterol. 2005;40:123–127.
Nagata N, Shimbo T, Akiyama J, et al. Predictability of gastric intestinal metaplasia by mottled patchy erythema seen on endoscopy. Gastroenterol Res.. 2011;4:203–209.
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Park, C.H., Kim, B., Chung, H. et al. Endoscopic Quality Indicators for Esophagogastroduodenoscopy in Gastric Cancer Screening. Dig Dis Sci 60, 38–46 (2015). https://doi.org/10.1007/s10620-014-3288-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10620-014-3288-y