The variation in post-endoscopy upper gastrointestinal cancer rates among endoscopy providers in England and associated factors - population-based study

Q: What is PEUGIC in this study?

PEUGIC refers to upper gastrointestinal cancers diagnosed 6 to 36 months after an endoscopy that did not diagnose cancer.

Q: How much did PEUGIC rates vary between endoscopy providers?

The national PEUGIC rate was 8.5%, with provider-level rates ranging from 5% to 13%.

Q: Which factors were associated with higher PEUGIC odds?

Factors included female sex, younger age compared with ≤60 years, greater comorbidity (Charlson score >4), history of esophageal ulcer or Barrett’s esophagus, esophageal stricture, gastric ulcer, and squamous cell carcinoma.

Sep 21, 2026

Uploaded by Ophelia

Background: Post-endoscopy upper gastrointestinal cancer (PEUGIC) functions as an important performance indicator for endoscopy quality. This study assesses how PEUGIC rates differ among endoscopy providers in England and identifies factors linked to these variations. Methods: A population-based, retrospective, case–control design analyzed national cancer registry and hospital episode statistics data for esophageal and gastric cancers diagnosed between 2009 and 2018, using multivariable logistic regression. Results: PEUGIC occurred in 8.5% overall, varying from 5% to 13% by provider.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Introduction

The variation in post-endoscopy upper gastrointestinal cancer rates among endoscopy providers in England and associated factors: a population-based study GRAPHICAL ABSTRACT Variation in post-endoscopy upper GI cancer (PEUGIC) rate in England and associated factors • PEUGIC: UGI cancer diagnosed within 6–36 months of anondiagnostic endoscopy • 98 801 patients with UGI cancer diagnosed in England between 2009 and 2018 • 8.5% categorized as PEUGIC OR, odds ratio; UGI, upper gastrointestinal. % PEUG IC rate, 2014–2018 0 500 1000 Total endoscopies after which UGI cancer was diagnosed, n | Associated factors | OR (95%CI) | | --- | --- | | Esophageal ulcer | 3.3 (3.1–3.5) | | Barrett’s esophagus | 3.2 (3.0–3.4) | | Esophageal stricture | 1.3 (1.2–1.4) | | Gastric ulcer | 1.6 (1.4–1.7) | | Squamous cell cancer | 1.5 (1.4–1.6) | Providers should aim to keep PEUGIC rate <7% Adjusted PEUGIC rate varied from 5% to 13% among endoscopy providers Authors Umair Kamran1 , Felicity Evison2, Eva Judith Ann Morris3, Matthew J Brookes4,5, Matthew David Rutter6,7 , Mimi McCord8, Nicola J Adderley9, Nigel Trudgill1,10 Institutions 1 Department of Gastroenterology, Sandwell and West Birmingham NHS Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland 2 Data Science, Research, Development and Innovation, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland 3 Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland 4 Department of Gastroenterology, The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom of Great Britain and Northern Ireland 5 Faculty of Science and Engineering, Research Institute in Healthcare Science, University of Wolverhampton, Wolverhampton, United Kingdom of Great Britain and Northern Ireland 6 Department of Gastroenterology, North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, United Kingdom of Great Britain and Northern Ireland 7 Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom of Great Britain and Northern Ireland 8 Heartburn Cancer UK, London, United Kingdom of Great Britain and Northern Ireland 9 Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland 10 Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland received 11.7.2023 accepted after revision 19.6.2024 published online 29.8.2024 Bibliography Endoscopy 2025; 57: 17–28 DOI 10.1055/a-2378-1464 ISSN 0013-726X Kamran Umair et al. The variation in… Endoscopy 2025; 57: 17–28 | © 2024. The Author(s) . 17 © 2024. The Author(s) . This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ([https://creativecommons.org/licenses/by-nc-nd/4.0/](https://creativecommons.org/licenses/by-nc-nd/4.0/)) Georg Thieme Verlag KG, Rüdigerstraße 14, 70469 Stuttgart, Germany Supplementary Material Supplementary Material is available at [https://doi.org/10.1055/a-2378-1464](https://doi.org/10.1055/a-2378-1464) Corresponding author Nigel Trudgill, MD, Department of Gastroenterology, Sandwell and West Birmingham NHS Trust, Hallam Street, Lyndon, West Bromwich B17 4HJ, United Kingdom [nigel.trudgill@nhs. net](nigel.trudgill@nhs. net) ABSTRACT Background Post-endoscopy upper gastrointestinal cancer (PEUGIC) is an important key performance indicator for endoscopy quality. We examined variation in PEUGIC rates among endoscopy providers in En

FAQs

What is PEUGIC in this study?

PEUGIC refers to upper gastrointestinal cancers diagnosed 6 to 36 months after an endoscopy that did not diagnose cancer.

How much did PEUGIC rates vary between endoscopy providers?

The national PEUGIC rate was 8.5%, with provider-level rates ranging from 5% to 13%.

Which factors were associated with higher PEUGIC odds?

Factors included female sex, younger age compared with ≤60 years, greater comorbidity (Charlson score >4), history of esophageal ulcer or Barrett’s esophagus, esophageal stricture, gastric ulcer, and squamous cell carcinoma.

Sep 21, 2026

Uploaded by Ophelia