Coverage of diagnostic upper gastrointestinal endoscopy for the prevention of gastric cancer in Chile: results from the 2009-2010 National Health Survey

• Published in: Revista medíca de Chile 2015-09, Vol.143 (9), p.1198-1205
• Main Authors: Latorre S, Gonzalo, Álvarez O, Jorge, Ivanovic-Zuvic S, Danisa, Valdivia C, Gonzalo, Margozzini M, Paula, Chianale B, José, Miquel P, Juan Francisco
• Format: Article
• Language: Spanish
• Subjects: Abdominal Pain - drug therapy; Abdominal Pain - epidemiology; Adult; Age Distribution; Aged; Aged, 80 and over; Chile - epidemiology; Educational Status; Endoscopy, Gastrointestinal - methods; Endoscopy, Gastrointestinal - statistics & numerical data; Female; Gastrointestinal Hemorrhage - drug therapy; Gastrointestinal Hemorrhage - epidemiology; Health Surveys - statistics & numerical data; Histamine H2 Antagonists - therapeutic use; Humans; Male; Mass Screening - methods; Mass Screening - statistics & numerical data; Multivariate Analysis; Prevalence; Proton Pump Inhibitors - therapeutic use; Residence Characteristics - statistics & numerical data; Sex Distribution; Stomach Neoplasms - diagnosis; Stomach Neoplasms - epidemiology; Stomach Neoplasms - prevention & control
• ISSN: 0717-6163
• DOI: 10.4067/S0034-98872015000900014

In Chile, gastric cancer (GC) is a major cause of cancer related deaths. The current screening strategy consists of an upper gastrointestinal endoscopy (UGE) for people aged 40 years or more with epigastric pain. To evaluate the diagnostic coverage of the use of UGE for early detection of GC in Chile. As part of the digestive module of the 2009-10 National Health Survey, 5293 adults over 15 years were asked about the presence of epigastric pain, possible upper gastrointestinal bleeding (PUGB), use of proton pump inhibitors (PPIs) or histamine H2-receptor antagonists (H2RAs), family history of GC and having performed an UGE. Persistent epigastric pain was observed in 3.4% of the population. PUGB signs were observed in 3.3% of the population. The prevalence of PPIs and H2RAs use was 4.3% and 2.2% respectively, reaching 21.6% in people aged 70 years and older. Life span prevalence of UGE was 18.3%, with differences by region, health insurance and educational level. UGE coverage in people aged 40 years or older with and without persistent epigastric pain was 14.4% and 3.2% respectively (Odds ratio 4.8, p < 0.01). The prevalence of UGE was similar among people with or without PUGB or family history of CG. The estimated coverage of the current GC prevention strategy in Chile is 14.4%, evaluated at a population level. Further studies are required to determine the impact of this strategy on early GC diagnosis and mortality.