Urgent endoscopy is indicated for suspected upper gastrointestinal malignancy.
However, there is limited evidence on the age threshold for performing urgent endoscopy in uncomplicated dyspepsia.
Dr Phull and colleagues quantified the risk of missing upper gastrointestinal malignancy within Scotland.
The investigative team assessed the risk if the age threshold for urgent endoscopy in uncomplicated dyspepsia was increased from 45 to 55 years.
The team analyzed data collected prospectively by the Scottish Audit of Gastric and Oesophageal Cancer.
'Alarm' features at presentation were defined as dysphagia, as was weight loss, gastrointestinal bleeding, anaemia, and vomiting.
History of gastric surgery and history of peptic ulcer disease was also defined as alarm features.
|290 of 3293 patients diagnosed were under 55 years of age|
|Alimentary Pharmacology & Therapeutics|
The investigators reported that out of 3293 patients diagnosed with upper gastrointestinal malignancy, 290 patients were under 55 years of age.
The team noted that 21 of the patients aged under 55 years had no alarm features, 12 were aged 45 to 55 years and 9 were aged less than 45 years.
Only 2 patients underwent potentially curative surgery.
Dr Phull and his team concluded, “Upper gastrointestinal malignancy is uncommon under 55 years of age and most of the patients present with alarm features.”
“Raising the age threshold for endoscopy for new-onset uncomplicated dyspepsia from 45 to 55 years would not impact adversely on the diagnosis or outcome of upper gastrointestinal malignancy.”