TY - JOUR
T1 - Yield of Repeat Endoscopy for Barrett's Esophagus After Normal Index Endoscopy
AU - Rubenstein, Joel H.
AU - Burns, Jennifer A.
AU - Arasim, Maria E.
AU - Firsht, Elizabeth M.
AU - Harbrecht, Matthew
AU - Widerquist, Marilla
AU - Evans, Richard R.
AU - Inadomi, John M.
AU - Chang, Joy W.
AU - Hazelton, William D.
AU - Hur, Chin
AU - Kurlander, Jacob E.
AU - Lim, Francesca
AU - Luebeck, Georg
AU - Macdonald, Peter W.
AU - Reddy, Chanakyaram A.
AU - Saini, Sameer D.
AU - Tan, Sarah Xinhui
AU - Waljee, Akbar K.
AU - Lansdorp-Vogelaar, Iris
N1 - Financial support: American Society for Gastrointestinal Endoscopy through the 2020 Research Award. The ASGE did not have any role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
Publisher Copyright:
© 2023 Wolters Kluwer Health. All rights reserved.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - INTRODUCTION:Guidelines suggest 1-time screening with esophagogastroduodenoscopy (EGD) for Barrett's esophagus (BE) in individuals at an increased risk of esophageal adenocarcinoma (EAC). We aimed to estimate the yield of repeat EGD performed at prolonged intervals after a normal index EGD.METHODS:We conducted a national retrospective analysis within the U S Veterans Health Administration, identifying patients with a normal index EGD between 2003 and 2009 who subsequently had a repeat EGD. We tabulated the proportion with a new diagnosis of BE, EAC, or esophagogastric junction adenocarcinoma (EGJAC) and conducted manual chart review of a sample. We fitted logistic regression models for the odds of a new diagnosis of BE/EAC/EGJAC.RESULTS:We identified 71,216 individuals who had a repeat EGD between 1 and 16 years after an index EGD without billing or cancer registry codes for BE/EAC/EGJAC. Of them, 4,088 had a new billing or cancer registry code for BE/EAC/EGJAC after the repeat EGD. On manual review of a stratified sample, most did not truly have new BE/EAC/EGJAC. A longer duration between EGD was associated with greater odds of a new diagnosis (adjusted odds ratio [aOR] for each 5 years 1.31; 95% confidence interval [CI] 1.19-1.44), particularly among those who were younger during the index EGD (ages 19-29 years: aOR 3.92; 95% CI 1.24-12.4; ages 60-69 years: aOR 1.19; 95% CI 1.01-1.40).DISCUSSION:The yield of repeat EGD for BE/EAC/EGJAC seems to increase with time after a normal index EGD, particularly for younger individuals. Prospective studies are warranted to confirm these findings.
AB - INTRODUCTION:Guidelines suggest 1-time screening with esophagogastroduodenoscopy (EGD) for Barrett's esophagus (BE) in individuals at an increased risk of esophageal adenocarcinoma (EAC). We aimed to estimate the yield of repeat EGD performed at prolonged intervals after a normal index EGD.METHODS:We conducted a national retrospective analysis within the U S Veterans Health Administration, identifying patients with a normal index EGD between 2003 and 2009 who subsequently had a repeat EGD. We tabulated the proportion with a new diagnosis of BE, EAC, or esophagogastric junction adenocarcinoma (EGJAC) and conducted manual chart review of a sample. We fitted logistic regression models for the odds of a new diagnosis of BE/EAC/EGJAC.RESULTS:We identified 71,216 individuals who had a repeat EGD between 1 and 16 years after an index EGD without billing or cancer registry codes for BE/EAC/EGJAC. Of them, 4,088 had a new billing or cancer registry code for BE/EAC/EGJAC after the repeat EGD. On manual review of a stratified sample, most did not truly have new BE/EAC/EGJAC. A longer duration between EGD was associated with greater odds of a new diagnosis (adjusted odds ratio [aOR] for each 5 years 1.31; 95% confidence interval [CI] 1.19-1.44), particularly among those who were younger during the index EGD (ages 19-29 years: aOR 3.92; 95% CI 1.24-12.4; ages 60-69 years: aOR 1.19; 95% CI 1.01-1.40).DISCUSSION:The yield of repeat EGD for BE/EAC/EGJAC seems to increase with time after a normal index EGD, particularly for younger individuals. Prospective studies are warranted to confirm these findings.
UR - http://www.scopus.com/inward/record.url?scp=85164211812&partnerID=8YFLogxK
U2 - 10.14309/ajg.0000000000002204
DO - 10.14309/ajg.0000000000002204
M3 - Article
C2 - 36716445
AN - SCOPUS:85164211812
SN - 0002-9270
VL - 118
SP - 1168
EP - 1174
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 7
ER -
