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• W1988904409 abstract "Background: A “test-and-treat” strategy for H pylori infection has been recommended in Europe and North America as safe and cost-effective for management of patients with dyspepsia. The primary aim of this study was to determine the frequency of gastroesophageal cancer in 2 groups of patients with dyspepsia: those 45 years of age or younger without “alarm” symptoms (low-risk group) and patients over 45 years of age or any patient with “alarm” symptoms (high-risk group). A secondary aim was to determine the frequency of gastric cancer among patients in the low-risk group with or without a positive serology for H pylori. Methods: Patients with persistent dyspepsia were recruited from 4 regional hospitals in Hong Kong. Those in the low-risk group were evaluated for H pylori by using a whole blood serology test; they underwent endoscopy within 1 week. Those in the high-risk group and those taking nonsteroidal anti-inflammatory drugs (NSAIDs) underwent endoscopy promptly. Alarm symptoms were as follows: weight loss (10 or more pounds over 8 weeks), recurrent vomiting, dysphagia, bleeding, or anemia. Results: Of 2627 patients enrolled, 1017 were in the low-risk group and 1610 in the high-risk group. Twenty-three patients (0.9%) had gastroesophageal cancers (20 gastric, 3 esophageal). Four patients with cancer (17.4%) were in the low-risk group (3 gastric, 1 esophageal); all except the patient with esophageal cancer had a positive serology test. In the high-risk group, 19 patients had cancer (17 gastric, 2 esophageal). Conclusion: Gastric cancer is relatively frequent among young patients with dyspepsia who have no alarm features in Hong Kong. This finding raise concerns as to the safety of the “test-and-treat” strategy for the management of patients with dyspepsia in Asia. (Gastrointest Endosc 2001;54:454-8.)" @default.
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• W1988904409 date "2001-10-01" @default.
• W1988904409 modified "2023-09-27" @default.
• W1988904409 title "Incidence of gastroesophageal malignancy in patients with dyspepsia in Hong Kong: Implications for screening strategies" @default.
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• W1988904409 doi "https://doi.org/10.1067/mge.2001.118254" @default.
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