Abstract
BackgroundDyspepsia is a common cause of physician visits. If and when endoscopy should be performed depend on the regions and the populations. This study aimed to identify the current risk factors predictive of upper gastrointestinal malignancy or peptic ulcer in China with high prevalence of gastric cancer.MethodsA questionnaire was conducted among consecutive outpatients undergoing their first esophagogastroduodenoscopy for dyspepsia. Symptoms other than alarm symptoms in this study were defined as uncomplicated dyspepsia.Results4310 outpatients (mean age 44, median 42, range 14–86) were included in the final analyses. Significant pathology was found in 13.8% (595/4310) patients including peptic ulcer (12.3%) and upper gastrointestinal malignancy (1.5%). Age, male sex and alarm symptoms were significantly associated with malignancy. The age cut-off identified for upper gastrointestinal malignancy was 56 years among patients with uncomplicated dyspepsia, which was similar to the combined cutoff of age and gender.ConclusionsAge should be considered as the primary predictor for upper gastrointestinal malignancy in Chinese patients with uncomplicated dyspepsia. 56 could probably be the optimal age to identify those lesions in this population. Trial registration: Chictr.org (ChiCTR2000040775).
Highlights
Dyspepsia is a common cause of physician visits
The high prevalence of peptic ulcer and gastric cancer in China supports the use of endoscopy for evaluation of dyspepsia, its use for universal screening remains controversial in China and has not been adopted as standard policy
rapid urease tests (RUT) was not performed in 19 patients or/and H. pylori histology was not done because a malignant lesion obstruction prevented endoscopic entry or they were taking anticoagulant drugs
Summary
Dyspepsia is a common cause of physician visits. If and when endoscopy should be performed depend on the regions and the populations. This study aimed to identify the current risk factors predictive of upper gastrointestinal malignancy or peptic ulcer in China with high prevalence of gastric cancer. The role EGD in the evaluation of patients with uninvestigated dyspepsia varies depending on the background prevalence of peptic ulcer and gastric cancer in the population as well as factors such as age, sex, presence or absence of symptoms, family history, use of gastrotoxic or antisecretory drugs, etc [9]. The high prevalence of peptic ulcer and gastric cancer in China supports the use of endoscopy for evaluation of dyspepsia, its use for universal screening remains controversial in China and has not been adopted as standard policy. The aim of this study was to investigate the prevalence of different upper gastrointestinal pathologies in a large Chinese population presenting to hospital because of upper gastrointestinal symptoms with the goal of identifying risk factors useful to predict major endoscopic findings in this population
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