Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists
Objective The documented variation in gastric cancer (GC) detection among endoscopists has often been dismissed as a coincidental artefact of the low incidence of gastric neoplasms; it is not considered associated with differences in physicians’ performance of the esophagogastroduodenoscopy procedur...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-11-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/10/1/e001143.full |
| _version_ | 1797371492544020480 |
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| author | Daisuke Murakami Yuji Amano Masayuki Yamato Takayoshi Nishino Makoto Arai |
| author_facet | Daisuke Murakami Yuji Amano Masayuki Yamato Takayoshi Nishino Makoto Arai |
| author_sort | Daisuke Murakami |
| collection | DOAJ |
| description | Objective The documented variation in gastric cancer (GC) detection among endoscopists has often been dismissed as a coincidental artefact of the low incidence of gastric neoplasms; it is not considered associated with differences in physicians’ performance of the esophagogastroduodenoscopy procedure. This study is to confirm whether significant variations among endoscopists in early GC detection suggest the individual performance of the upper endoscopy.Design A retrospective observational study at a single centre in Japan assessed the results of 218 early GCs detected during 25 688 routine esophagogastroduodenoscopies by 12 endoscopists. The main outcome was the rate of early GC detection for each endoscopist under the same circumstances. Other measures included the major diameters and locations of the lesions, Helicobacter pylori infection status, and baseline patient characteristics that could affect the prevalence of GC.Results The early GC detection rates exhibited wide variation among endoscopists (0.09%–2.87%) despite performing routine esophagogastroduodenoscopies in a population with a similar background. Endoscopists were assigned to a low-detection group (n=6; detection rate: 0.47% (range: 0.09%–0.55%)) and a high-detection group (n=5; detection rate: 0.83% (range: 0.63%–1.12%)), with the single highest detector analysed separately due to his distinct detection rate (2.87%). Endoscopists in the high-detection group had better detection rates for minute (major diameter ≤5 mm) and small (major diameter 6–10 mm) GCs than the low-detection group (0.19%/0.23% vs 0.085%/0.098%). These differences were significant (p<0.01), although there were no significant differences in detection of larger tumours (major diameter ≥11 mm; 0.40% vs 0.28%; p=0.13). The tumour location and H. pylori status were similar in the low-detection group, high-detection group and for the highest detector.Conclusion Significant variation in the detection of hard-to-find, smaller GCs may reflect individual performance of the examination. |
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| id | doaj.art-6d21d841e9cb479680be0609d5c65d5f |
| institution | Directory Open Access Journal |
| issn | 2054-4774 |
| language | English |
| last_indexed | 2024-03-08T18:21:03Z |
| publishDate | 2023-11-01 |
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| series | BMJ Open Gastroenterology |
| spelling | doaj.art-6d21d841e9cb479680be0609d5c65d5f2023-12-30T22:35:06ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742023-11-0110110.1136/bmjgast-2023-001143Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopistsDaisuke Murakami0Yuji Amano1Masayuki Yamato2Takayoshi Nishino3Makoto Arai4Department of Gastroenterology, Tokyo Women`s Medical University Yachiyo Medical Centre, Yachiyo, Chiba, JapanDepartment of Gastroenterology and Endoscopy, New Tokyo Hospital, Mtsudo, Chiba, JapanInstitute of Advanced Biomedical Engineering and Science, Tokyo Women`s Medical University, Shinjuku, Tokyo, JapanDepartment of Gastroenterology, Tokyo Women`s Medical University Yachiyo Medical Centre, Yachiyo, Chiba, JapanDepartment of Gastroenterology, Tokyo Women`s Medical University Yachiyo Medical Centre, Yachiyo, Chiba, JapanObjective The documented variation in gastric cancer (GC) detection among endoscopists has often been dismissed as a coincidental artefact of the low incidence of gastric neoplasms; it is not considered associated with differences in physicians’ performance of the esophagogastroduodenoscopy procedure. This study is to confirm whether significant variations among endoscopists in early GC detection suggest the individual performance of the upper endoscopy.Design A retrospective observational study at a single centre in Japan assessed the results of 218 early GCs detected during 25 688 routine esophagogastroduodenoscopies by 12 endoscopists. The main outcome was the rate of early GC detection for each endoscopist under the same circumstances. Other measures included the major diameters and locations of the lesions, Helicobacter pylori infection status, and baseline patient characteristics that could affect the prevalence of GC.Results The early GC detection rates exhibited wide variation among endoscopists (0.09%–2.87%) despite performing routine esophagogastroduodenoscopies in a population with a similar background. Endoscopists were assigned to a low-detection group (n=6; detection rate: 0.47% (range: 0.09%–0.55%)) and a high-detection group (n=5; detection rate: 0.83% (range: 0.63%–1.12%)), with the single highest detector analysed separately due to his distinct detection rate (2.87%). Endoscopists in the high-detection group had better detection rates for minute (major diameter ≤5 mm) and small (major diameter 6–10 mm) GCs than the low-detection group (0.19%/0.23% vs 0.085%/0.098%). These differences were significant (p<0.01), although there were no significant differences in detection of larger tumours (major diameter ≥11 mm; 0.40% vs 0.28%; p=0.13). The tumour location and H. pylori status were similar in the low-detection group, high-detection group and for the highest detector.Conclusion Significant variation in the detection of hard-to-find, smaller GCs may reflect individual performance of the examination.https://bmjopengastro.bmj.com/content/10/1/e001143.full |
| spellingShingle | Daisuke Murakami Yuji Amano Masayuki Yamato Takayoshi Nishino Makoto Arai Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists BMJ Open Gastroenterology |
| title | Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists |
| title_full | Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists |
| title_fullStr | Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists |
| title_full_unstemmed | Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists |
| title_short | Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists |
| title_sort | variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists |
| url | https://bmjopengastro.bmj.com/content/10/1/e001143.full |
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