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Endoscopists were grouped by examination time (fast/slow) and by number of images (small/large), with 5 minutes or 50 images as cutoffs. Faster and fewer-image observations were linked to lower overall UGI cancer detection, while repeated endoscopy within 2 years increased detection. Sub-analyses showed a negative association between gastric cancer detection and gastric images \u003C35, and a trend for pharyngeal and esophageal cancers with esophageal images \u003C11. 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number of images and 2-year interval affect cancer detection in screening esophagogastroduodenoscopy An observational study  \nKazuhiro Kashiwagi, MDa ,b ,* , Toshifumi Yoshida, MDa , Kayoko Fukuhara, MDa , Rieko Bessho, MDa ,  \nHitoshi Ichikawa, MDa , Nagamu Inoue, MDa , Hiromasa Takaishi, MDa , Yasushi Iwao, MDa , Takanori Kanai, MDc  \n\n| Abstract\u003Cbr>We aimed to identify quality indicator for esophagogastroduodenoscopy for detecting upper gastrointestinal (UGI) cancer. Data from 43,526 consecutive health checkups from August 2012 to January 2022 were retrospectively collected. The study ultimately analyzed 42,387 examinations by 12 endoscopists who performed more than 1000 examinations, including all cancers detected. These endoscopists were classified either into fast/slow group based on their mean examination time for a normal finding of esophagogastroduodenoscopy during their first year of the examination, or small/large group based on number of endoscopic images, respectively. The association between UGI cancer detection rate and examination time or the number of images was analyzed, using 5 minutes or 50 images as cutoff values. The detection rate of overall (8 pharyngeal, 39 esophageal, 69 gastric) cancers in the fast, slow, small, and large groups were 0 . 17%, 0.32%, 0.21%, and 0.31%, respectively. On multivariable analysis, endoscopists in the fast group or the small group were less likely to detect overall UGI cancer (OR: 0.596, 95% CI: 0.373–0.952, P = .030; OR: 0.652, 95% CI: 0.434–0.979, P = .039) . Additionally, repeated endoscopy within 2 years had a higher overall cancer detection rate, compared with repeated screening after 2 years. In a sub-analysis, a significant negative relationship was found between the detection rate of gastric cancer and the number of gastric images \u003C 35 (OR: 0.305, 95% CI: 0.189–0.492, P = .000) . There was also a negative correlation trend between the detection rate of pharyngeal and esophageal cancers and the number of esophageal images \u003C 11 (OR: 0.395, 95% CI: 0.156–1.001, P = .050) . The optimal number of images and screening 2-year interval are considered useful quality indicators for detecting UGI cancer. This study also suggests that a total of 50 images, or 35 images of the stomach are suitable for detecting UGI cancer, or gastric cancer, during screening endoscopy. |\n| --- |\n| Abbreviations: BLI = blue light imaging, EGD = esophagogastroduodenoscopy, IEE = image-enhanced endoscopy, NBI = narrow band imaging, UGI = upper gastrointestinal. |\n| Keywords: examination time, number of endoscopic images, screening esophagogastroduodenoscopy, upper gastrointestinal cancer |\n\n1. Introduction  \nEsophagogastroduodenoscopy (EGD) is widely performed for early detection of cancers as well as nonlesions in the upper gastrointestinal (UGI) tract. The Korean national cancer screening program demonstrated the effect of endoscopic screening on gastric cancer mortality.[1] However, the missing rate for UGI cancers on routine EGD has been reported to vary between 9% and 20%.[2–6] Moreover, according to a Japanese large-scale survey[7] complied 46,529 patients with esophageal cancer experienced at 409 facilities, only 538 (1.2%) patients were detected through health screening program. Therefore, quality indicator  \nThe authors have no funding and conflicts of interest to disclose.  \nAll data generated or analyzed during this study are included in this published article [and its supplementary information files].  \na Center for Preventive Medicine, Keio University, Tokyo, Japan, b Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, School of Medicine, Keio University, Tokyo, Japan, c Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.  \n* Correspondence: Kazuhiro Kashiwagi, Center for Preventive Medicine, Keio University, \\#7 Azabudai Hills Mori JP Tower, 1-3-1 Az","cbCaimq0nMxFE9JB","https://ap.wps.com/l/cbCaimq0nMxFE9JB","pdf",652454,"English","# Introduction\n## Aim and rationale for EGD quality indicators\n## Background on missed UGI cancers and existing standards\n# Study design and methods\n## Data source and inclusion of examinations\n## Endoscopist grouping by time and image number\n## Outcomes and statistical analysis\n# Results\n## Detection rates by time/image groups\n## Multivariable associations\n## Impact of repeated screening interval\n## Sub-analysis for gastric, pharyngeal, and esophageal cancers","[{\"question\":\"What was the primary goal of the study on screening EGD?\",\"answer\":\"To identify quality indicators for esophagogastroduodenoscopy that improve detection of upper gastrointestinal (UGI) cancer.\"},{\"question\":\"How were endoscopists classified for analysis?\",\"answer\":\"They were classified into fast/slow groups based on mean examination time for normal findings during the first year, and into small/large groups based on the number of endoscopic images.\"},{\"question\":\"What interval effect did repeated endoscopy show within 2 years?\",\"answer\":\"Repeated endoscopy within 2 years produced a higher overall cancer detection rate compared with repeated screening after 2 years.\"}]","Optimal number of images and 2-year interval affect cancer detection in screening esophagogastroduodenoscopy - An observational study | PDF",1789982492,18]