PTU-019 Quality of Upper Gastrointestinal Endoscopy Reporting in Suspected Cancer Patients

Abstract

Introduction Accurate endoscopy reporting is vital for upper gastrointestinal (GI) cancer management decisions. Effects of poor reporting are unknown but they are likely to cause delay in providing definitive treatment plans. Methods The Somerset Upper GI cancer database was used to identify patients between March 2014 and February 2015. Endoscopy report obtained from Endobase, radiological imaging report from PACS and local cancer multi-disciplinary team (MDT) index outcomes were then used to assess reporting quality and draw comparison. Reports were assessed against an expected ideal reporting criteria (anatomic extent of examination and its limitations, tissue samples obtained, description of findings, diagnostic impression and photodocumentation), against which the crucial computed tomography (CT) findings and subsequent MDT decisions could be made. Results A 12 month sample size of 84 confirmed upper GI cancer patients were identified (68% males; median age 70 years). Median time difference between endoscopy and staging CT scan was 7 days (range 0–46 days). In 86% (n = 72) the endoscopist reported the exact tumour location when correlated to CT findings. Only 56% (n = 47) mentioned that biopsies had been taken but of these only 51% (n = 24) mentioned the number of biopsies taken. All the visualised lesions had a reported description of how the lesion appeared i.e. malignant features. In total, 19 (23%) patients were identified having repeat gastroscopies and of these 6 (7%) were felt to be avoidable repeats. Of these, 2 were repeated for clarification of previous endoscopy reports while 4 were required due to insufficient biopsies for adequate histological confirmation of cancer. Overall the delay in organising these avoidable repeat gastroscopies ranged from 14–69 days (median 16.5). Of the 6 index gastroscopies that required repeating, 3 were undertaken by GI consultants (two surgeons, one physician), 1 trainee endoscopist, 1 nurse endoscopist, 1 acute physician consultant endoscopist. Conclusion Poor endoscopy reporting practice can cause significant delays in cancer diagnosis and management. Some technical difficulties are inevitable in clinical practice however attention to details in report is important. We recommend that every endoscopy unit must ensure that regular internal audits on endoscopy reporting are undertaken for quality assurance. Disclosure of Interest None Declared