Aims
The aim of the study was to determine differences in the detection of precancerous conditions (PC) and neoplastic lesions between asymptomatic and symptomatic patients who referred to esophagogastroduodenoscopy (EGD).
Methods
It was a single center, retrospective study conducted from January to September 2024. During this period patients who underwent diagnostic and screening EGD were analyzed.
Results
Among 2357 patients who underwent EGD and the data collection 418 were excluded from study, and 1939 were included (mean age 51.7±14.3; 1150 (59.2%) female), among which 1683 were symptomatic and 256 asymptomatic.
The incidence of dysplasia was 0.4% (n=1/256) in asymptomatic vs 2.14 % symptomatic (p=0.07) and cancers 0% (n=0/256) in asymptomatic vs 0.3% (n=5/1683, p=0.99) symptomatic patients, which revealed no significant differences in both groups. The incidence of BE (Barrett’s esophagus) was similar in both groups; 0.4% (n=1/256) asymptomatic vs 1.18% symptomatic (n=20/1683) (p=0.53). Subsequently, we observed similar occurrence of AG/GIM (atrophic gastritis, gastric intestinal metaplasia) in both groups, asymptomatic 11.7% (n=30/256) vs 10.5% (n=177/1683) symptomatic (p=0.79). Severity of AG/GIM assessed with OLGA/OLGIM staging revealed no difference between both groups in occurrence of advanced stages of atrophic gastritis (OLGA/OLGIM III-IV): asymptomatic 1.1% (n=3/256) vs 1.1% (n=20/1683) symptomatic (p=0.82).
In the multivariable regression analysis risk factors such as male sex (OR=0.557, 95% CI=0.285 - 1.089), presence of alarm symptoms (OR=0.355, 95% CI= 0.048 - 2.646). presence of any symptoms (OR=6.284, 95% CI=0.849 – 46.519) and sedation (OR=0.793, 95% CI=0.374 - 1.685), were not related to the detection of upper gastrointestinal neoplasia with the only risk factor being age (OR=1.047, 95% CI=1.022-1.072). None of assessed factors were associated with higher risk of PC ( – age (OR=1.001, 95% CI=0.992-1.010), male sex (OR=1.072, 95% CI=0.824-1.394), alarm symptoms (OR=0.824, 95% CI=0.497-1.367) presence of any symptoms (OR= 1.191, 95% CI=0.827-1.715), sedation (OR=0.822, 95% CI=0.584-1.157), adequate cleanliness (OR=1.136, 95% CI=0.653-1.977).
Conclusions
Presence of symptoms was not related to PC nor neoplasia detection. These findings underscore the need for identification additional risk factors and developing effective screening programs.