Endoscopy 2020; 52(S 01): S250-S251
DOI: 10.1055/s-0040-1704784
ESGE Days 2020 ePoster presentations
Thursday, April 23, 2020 09:00 – 17:00 Clinical endoscopic practice ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

SYSTEMATIC UPPER ENDOSCOPY CONCOMITANT WITH COLONOSCOPY PERFORMED WITHIN THE COLO-RECTAL CANCER SCREENING PROGRAM: IMPACT ON THE PATIENT-MANAGEMENT STRATEGY

O Planade
1   Nantes University Hospital, Institut des Maladies de l’Appareil Digestif, Nantes, France
,
B Dessomme
2   Nantes University Hospital, Service d’Evaluation Médicale et d’Epidémiologie, Nantes, France
,
N Chapelle
1   Nantes University Hospital, Institut des Maladies de l’Appareil Digestif, Nantes, France
,
M Verdier
1   Nantes University Hospital, Institut des Maladies de l’Appareil Digestif, Nantes, France
,
E Duchalais
1   Nantes University Hospital, Institut des Maladies de l’Appareil Digestif, Nantes, France
,
E Coron
1   Nantes University Hospital, Institut des Maladies de l’Appareil Digestif, Nantes, France
,
JF Mosnier
3   Nantes University Hospital, Service d’Anatomie et Cytologie Pathologiques, Nantes, France
,
T Matysiak-Budnik
1   Nantes University Hospital, Institut des Maladies de l’Appareil Digestif, Nantes, France
,
Y Touchefeu
1   Nantes University Hospital, Institut des Maladies de l’Appareil Digestif, Nantes, France
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 

Aims The French screening program for colorectal cancer is based on a fecal immunological test (FIT), followed by colonoscopy in case of its positivity. The interest of adding a concomitant upper endoscopy, to detect upper digestive lesions (precancerous or others), is still debated. We aimed to evaluate the frequency of upper digestive lesions detected by upper endoscopy, performed concomitantly with colonoscopy for positive FIT, and their impact on the management of patients (i.e. surveillance, medical treatment, endoscopic or surgical procedure).

Methods Data of all patients who consulted for a positive FIT between May 2016 and May 2019 in our center, and for whom concomitant upper endoscopy and colonoscopy were performed, were analyzed retrospectively. Patients with significant history of upper gastrointestinal disease, or active gastrointestinal symptoms were excluded.

Results One hundred patients were included (median age (min-max): 62 (50–75), men 64%). Macroscopic and/or microscopic upper digestive lesions were found in 58 of them (58%): Helicobacter pylori infection in 17 patients, gastric precancerous lesions in 9 patients (chronic atrophic gastritis with intestinal metaplasia, n = 8; low grade dysplasia n = 1), and Barrett’s esophagus requiring surveillance in 4 patients. The impact on the patients´ management was of 44% (n = 44/100), with no significant difference between the groups with positive or negative colonoscopy.

Conclusions A systematic upper endoscopy coupled with colonoscopy for positive FIT could represent an efficient strategy for upper digestive lesions screening in France as it reveals macroscopic and/or microscopic lesions in over 50% of patients, precancerous lesions in over 10% of patients, and has an overall impact on the management in over 40% of patients. Further studies are necessary to confirm these results and to evaluate cost-effectiveness of this approach.