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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(12): E1900-E1908
DOI: 10.1055/a-1594-1833
Original article

Quality management system for screening esophagogastroduodenoscopy improves detection of Helicobacter pylori-negative interval gastric cancer

Fumiaki Ishibashi
1   Koganei Tsurukame Clinic, Endoscopy Center, Tokyo, Japan
2   Shinjuku Tsurukame Clinic, Digestive Disease Center, Tokyo, Japan
,
Konomi Kobayashi
1   Koganei Tsurukame Clinic, Endoscopy Center, Tokyo, Japan
,
Tomohiro Kawakami
1   Koganei Tsurukame Clinic, Endoscopy Center, Tokyo, Japan
,
Ryu Tanaka
2   Shinjuku Tsurukame Clinic, Digestive Disease Center, Tokyo, Japan
,
Kazuaki Sugihara
2   Shinjuku Tsurukame Clinic, Digestive Disease Center, Tokyo, Japan
3   Mirraza Shinjuku Tsurukame Clinic, Tokyo, Japan
,
Satoshi Baba
2   Shinjuku Tsurukame Clinic, Digestive Disease Center, Tokyo, Japan
4   Yotsuya Medical Cube, Endoscopy Center, Tokyo, Japan
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Quality management system for screening esophagogastroduodenoscopy improves detection of Helicobacter pylori-negative interval gastric cancerEndosc Int Open 2021; 09(12): C12-C12
DOI: 10.1055/a-1843-2558

Abstract

Background and study aims Double-checking the findings of examinations is necessary for endoscopy quality control in gastric cancer screening; however, there have been no reports showing its effectiveness. We prospectively analyzed the effectiveness of a quality management system (QMS) in endoscopy for gastric cancer screening.

Patients and methods QMS was defined as having images and reports checked by a second endoscopist on the same day and reporting inconsistencies to the examining endoscopist. Patients diagnosed with early gastric cancer (EGC) in the 2 years before and after the introduction of QMS were divided into two groups: the interval cancer group, which included those for whom cancer was detected within 1 year of the last endoscopy and the noninterval cancer group. Changes in detection rates were compared.

Results Before the introduction of QMS, 11 interval EGC cases were diagnosed among 36,189 endoscopies, whereas after the introduction, 32 interval ECG cases were diagnosed among 38,290 endoscopies (P = 0.004). Fifteen noninterval EGC cases were diagnosed before the introduction, while 12 noninterval EGC cases were diagnosed after the introduction; no significant difference was observed. Subanalyses by Helicobacter pylori (HP) infection status revealed no difference in the detection rate among HP-positive EGC patients, but the detection rates among HP-eradicated and HP-naïve EGC patients were improved (P = 0.005 and P = 0.011). Logistic regression analysis showed that QMS was an independent predictor for detection of HP-negative interval EGC (P = 0.017, OR = 4.4, 95 % CI: 2.0–9.7).

Conclusions QMS improved the detection rate for HP-negative interval early gastric cancer. (UMIN000042991)



Publication History

Received: 05 May 2021

Accepted: 13 August 2021

Article published online:
14 December 2021

© 2021. 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/)

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