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Article: Incidence of gastroesophageal malignancy in patients with dyspepsia in Hong Kong: Implications for screening strategies

TitleIncidence of gastroesophageal malignancy in patients with dyspepsia in Hong Kong: Implications for screening strategies
Authors
Issue Date2001
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/gie
Citation
Gastrointestinal Endoscopy, 2001, v. 54 n. 4, p. 454-458 How to Cite?
AbstractBackground: A "test-and-treat" strategy for H pylori infection has been recommended in Europe and North America as safe and cost-effective for management of patients with dyspepsia. The primary aim of this study was to determine the frequency of gastroesophageal cancer in 2 groups of patients with dyspepsia: those 45 years of age or younger without "alarm" symptoms (low-risk group) and patients over 45 years of age or any patient with "alarm" symptoms (high-risk group). A secondary aim was to determine the frequency of gastric cancer among patients in the low-risk group with or without a positive serology for H pylori. Methods: Patients with persistent dyspepsia were recruited from 4 regional hospitals in Hong Kong. Those in the low-risk group were evaluated for H pylori by using a whole blood serology test; they underwent endoscopy within 1 week.Those in the high-risk group and those taking non-steroidal anti-inflammatory drugs (NSAIDs) underwent endoscopy promptly. Alarm symptoms were as follows: weight loss (10 or more pounds over 8 weeks), recurrent vomiting, dysphagia, bleeding, or anemia. Results: Of 2627 patients enrolled, 1017 were in the low-risk group and 1610 in the high-risk group. Twenty-three patients (0.9%) had gastroesophageal cancers (20 gastric, 3 esophageal). Four patients with cancer (17.4%) were in the low-risk group (3 gastric, 1 esophageal); all except the patient with esophageal cancer had a positive serology test. In the high-risk group, 19 patients had cancer (17 gastric, 2 esophageal). Conclusion: Gastric cancer is relatively frequent among young patients with dyspepsia who have no alarm features in Hong Kong.This finding raise concerns as to the safety of the "test-and-treat" strategy for the management of patients with dyspepsia in Asia.
Persistent Identifierhttp://hdl.handle.net/10722/162535
ISSN
2015 Impact Factor: 6.217
2015 SCImago Journal Rankings: 2.390
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSung, JJYen_US
dc.contributor.authorLao, WCen_US
dc.contributor.authorLai, MSen_US
dc.contributor.authorLi, THen_US
dc.contributor.authorChan, FKLen_US
dc.contributor.authorWu, JCYen_US
dc.contributor.authorLeung, VKSen_US
dc.contributor.authorLuk, YWen_US
dc.contributor.authorKung, NNSen_US
dc.contributor.authorChing, JYLen_US
dc.contributor.authorLeung, WKen_US
dc.contributor.authorLau, Jen_US
dc.contributor.authorChung, SJYen_US
dc.date.accessioned2012-09-05T05:20:53Z-
dc.date.available2012-09-05T05:20:53Z-
dc.date.issued2001en_US
dc.identifier.citationGastrointestinal Endoscopy, 2001, v. 54 n. 4, p. 454-458en_US
dc.identifier.issn0016-5107en_US
dc.identifier.urihttp://hdl.handle.net/10722/162535-
dc.description.abstractBackground: A "test-and-treat" strategy for H pylori infection has been recommended in Europe and North America as safe and cost-effective for management of patients with dyspepsia. The primary aim of this study was to determine the frequency of gastroesophageal cancer in 2 groups of patients with dyspepsia: those 45 years of age or younger without "alarm" symptoms (low-risk group) and patients over 45 years of age or any patient with "alarm" symptoms (high-risk group). A secondary aim was to determine the frequency of gastric cancer among patients in the low-risk group with or without a positive serology for H pylori. Methods: Patients with persistent dyspepsia were recruited from 4 regional hospitals in Hong Kong. Those in the low-risk group were evaluated for H pylori by using a whole blood serology test; they underwent endoscopy within 1 week.Those in the high-risk group and those taking non-steroidal anti-inflammatory drugs (NSAIDs) underwent endoscopy promptly. Alarm symptoms were as follows: weight loss (10 or more pounds over 8 weeks), recurrent vomiting, dysphagia, bleeding, or anemia. Results: Of 2627 patients enrolled, 1017 were in the low-risk group and 1610 in the high-risk group. Twenty-three patients (0.9%) had gastroesophageal cancers (20 gastric, 3 esophageal). Four patients with cancer (17.4%) were in the low-risk group (3 gastric, 1 esophageal); all except the patient with esophageal cancer had a positive serology test. In the high-risk group, 19 patients had cancer (17 gastric, 2 esophageal). Conclusion: Gastric cancer is relatively frequent among young patients with dyspepsia who have no alarm features in Hong Kong.This finding raise concerns as to the safety of the "test-and-treat" strategy for the management of patients with dyspepsia in Asia.en_US
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/gieen_US
dc.relation.ispartofGastrointestinal Endoscopyen_US
dc.subject.meshAdulten_US
dc.subject.meshDyspepsia - Epidemiologyen_US
dc.subject.meshEsophageal Neoplasms - Epidemiologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshIncidenceen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRisk Assessmenten_US
dc.subject.meshStomach Neoplasms - Epidemiologyen_US
dc.titleIncidence of gastroesophageal malignancy in patients with dyspepsia in Hong Kong: Implications for screening strategiesen_US
dc.typeArticleen_US
dc.identifier.emailLeung, WK:waikleung@hku.hken_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1067/mge.2001.118254en_US
dc.identifier.pmid11577306-
dc.identifier.scopuseid_2-s2.0-0035491817en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035491817&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume54en_US
dc.identifier.issue4en_US
dc.identifier.spage454en_US
dc.identifier.epage458en_US
dc.identifier.isiWOS:000171360000007-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridSung, JJY=35405352400en_US
dc.identifier.scopusauthoridLao, WC=7004183905en_US
dc.identifier.scopusauthoridLai, MS=7401807862en_US
dc.identifier.scopusauthoridLi, TH=7409727920en_US
dc.identifier.scopusauthoridChan, FKL=7202586434en_US
dc.identifier.scopusauthoridWu, JCY=7409253910en_US
dc.identifier.scopusauthoridLeung, VKS=7102336049en_US
dc.identifier.scopusauthoridLuk, YW=7004550268en_US
dc.identifier.scopusauthoridKung, NNS=6603573627en_US
dc.identifier.scopusauthoridChing, JYL=7005086238en_US
dc.identifier.scopusauthoridLeung, WK=7201504523en_US
dc.identifier.scopusauthoridLau, J=13907867100en_US
dc.identifier.scopusauthoridChung, SJY=7404292625en_US

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