Utility of screening esophagogastroduodenoscopy performed sequentially with endoscopic ultrasonography

Abstract Background: Gastric cancer screening using esophagogastroduodenoscopy is crucial in areas in which gastric cancer has a high incidence. To provide more opportunities for gastric cancer screening, we have a protocol of sequential esophagogastroduodenoscopy and endoscopic ultrasonography using each dedicated scope for patients with pancreaticobiliary disease; however, the usefulness of this protocol is not elucidated. This study aimed to investigate the utility of screening esophagogastroduodenoscopy in this protocol for the detection of gastric epithelial neoplasms. Methods: We investigated the utility of screening esophagogastroduodenoscopy performed sequentially with endoscopic ultrasonography for patients with pancreaticobiliary disease at our hospital between April 2020 and September 2022 and compared its detection rate for gastric epithelial neoplasms with that of gastric cancer screening at our medical checkup center. Additionally, a logistic regression model was used to identify factors affecting the detection of gastric epithelial neoplasms. Results: A total of 615 screening esophagogastroduodenoscopies were performed sequentially with endoscopic ultrasonography, and 10 (1.6%) gastric epithelial neoplasms were detected: early gastric cancer in 7 and gastric adenoma in 3. The detection rate of gastric epithelial neoplasms in the protocol was higher than that in the medical checkup center (1.6% vs. 0.2% [14/7,763], p <0.01). Additionally, using a magnification endoscope was the only independent factor affecting the detection of gastric epithelial neoplasms in the protocol (odds ratio, 9.53; 95% confidence interval, 1.98–45.90; p <0.01). Conclusions: A protocol of sequential esophagogastroduodenoscopy and endoscopic ultrasonography is recommended to detect gastric epithelial neoplasms. Additionally, magnification endoscopy may facilitate detection in this protocol.