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Digestive Diseases and Sciences

, Volume 60, Issue 4, pp 936–943 | Cite as

Risk Factors of Developing Interval Early Gastric Cancer After Negative Endoscopy

  • Young Sin Cho
  • Il-Kwun Chung
  • Ji Hyun Kim
  • Yunho Jung
  • Tae Hoon Lee
  • Sang-Heum Park
  • Sun-Joo Kim
Original Article

Abstract

Background

New or missed gastric cancer rates after negative endoscopy are high. However, the clinicopathologic characteristics of missed or interval early gastric cancer (EGC) are not well known. The aim of this study was to evaluate clinicopathologic and endoscopic characteristics of missed or interval EGC after negative endoscopy.

Methods

We retrospectively analyzed 1,055 patients with EGC confirmed by endoscopic resection or surgery between June 2006 and July 2013. Referred patients with diagnosed or suspected gastric neoplasms were excluded (n = 771). Interval EGC was defined as gastric cancer diagnosed within 2 years of negative endoscopy. Clinicopathologic characteristics of patients with initially detected and interval EGC and risk factors for interval EGC were investigated.

Results

Of 284 patients, 52 had interval EGC (18.3 %; mean age 65.4 years; average interval between diagnosis and previous endoscopy, 12.6 months). Tumors were significantly smaller (1.3 vs. 1.8 cm, P < 0.001), and the incidence of metaplasia was significantly higher (90.4 vs. 65.9 %, P < 0.001) for interval EGC than for initially detected EGC. And no symptoms (50 vs. 17.7 %, P < 0.001) were significantly associated with interval EGC. However, tumor location, differentiation, gross morphology, and Helicobacter pylori infection status did not differ significantly.

Conclusions

Subtle mucosal lesions with surrounding intestinal metaplasia were associated with interval EGC. Careful endoscopic screening for patients with intestinal metaplasia at short-term interval would be beneficial for decreasing interval EGC rates.

Keywords

Early gastric cancer Interval gastric cancer Missed gastric cancer 

Notes

Acknowledgments

This work was supported by the Soonchunhyang University Research Fund.

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Young Sin Cho
    • 1
  • Il-Kwun Chung
    • 1
  • Ji Hyun Kim
    • 1
  • Yunho Jung
    • 1
  • Tae Hoon Lee
    • 1
  • Sang-Heum Park
    • 1
  • Sun-Joo Kim
    • 1
  1. 1.Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of MedicineCheonan HospitalCheonan, ChoongnamRepublic of Korea

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