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Reasons for False Negatives in the Endoscopic Screening for Cancer in the Upper Gastrointestinal Tract
Author(s) -
O'CALLAGHAN Elena,
TAKAHASHI Hiroshi,
FUJITA Rikiya
Publication year - 1990
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1990.tb00333.x
Subject(s) - medicine , endoscopy , malignancy , population , cancer , gastroenterology , atrophic gastritis , lesion , colonoscopy , gastritis , stomach , surgery , colorectal cancer , environmental health
The following paper is a study of 119 gastric cancer lesions that were not diagnosed as malignant in the first gastroscopic examination. These cases were classified according to their endoscopic appearance, and the frequency with which they appeared was compared with the frequency of that type of lesion in the population that receives endoscopy. Gastric ulceration, adenomas, polyps, submucosal tumors, acute gastric mucosal lesions, and gastric redness appeared more frequently in the false negative group than in the population that receives endoscopy. Atrophic gastritis, duodenal ulceration, gastric ulcer scar and gastric erosion appeared less frequently in this group titan in the population that receives endoscopy. To evaluate whether malignancy should really have been suspected in the lesions, the gastroscopic pictures were reviewed by an expert endoscopist. In only 15% of the lesions was cancer not suspected by the expert endoscopist. Chromoscopy as an auxiliary method for the endoscopist was used in only about half of the cases. Depending on the experience of the endoscopist, some endoscopic findings appeared more often than others: i‐ INTERMEDIATE and BEGINNING endoscopists mainly mistook cancer for gastric ulceration. ii‐EXPERT endoscopists confused many more adenomas and polips. We conclude that some gastric lesions are more easily confused in regard to malignancy than others, and that the experience level of the endoscopist stakes hint or her more prone to confusing certain kinds of lesions.