Need for improvement in the evaluation of pre‐malignant upper gastro‐intestinal lesions in India: Results of a nationwide survey

Background and Aim Gastric and esophageal cancers are associated with high morbidity in India. In the absence of formal screening programs in India, it is essential that all elective esophago‐gastro‐duodenoscopies (EGDs), irrespective of indication, be also considered an opportunity to screen for pr...

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Published in:Journal of gastroenterology and hepatology 2022-11, Vol.37 (11), p.2113-2119
Main Authors: Madhu, Deepak, Krishnamurthy, Veeraraghavan, Natarajan, Thirumoorthi, Lakhtakia, Sundeep
Format: Article
Language:English
Subjects:
atrophic
Barrett esophagus
Best practice
Endoscopy
esophageal neoplasms
Gastric cancer
gastritis
Intestine
Lesions
Morbidity
stomach neoplasms
Surveys
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Summary:Background and Aim Gastric and esophageal cancers are associated with high morbidity in India. In the absence of formal screening programs in India, it is essential that all elective esophago‐gastro‐duodenoscopies (EGDs), irrespective of indication, be also considered an opportunity to screen for premalignant lesions. With this premise, we tried to assess the adherence to best practices in the detection of premalignant upper gastro‐intestinal lesions (PMUGIL) among endoscopists in India. We also evaluated the adequacy of training, availability of appropriate facilities, and differences between teaching and non‐teaching centers. Methods We disbursed a survey among endoscopists working in India, through the membership database of the Society of Gastrointestinal Endoscopists of India, by email and instant messaging. The responses were collected and subsequently analyzed. Results We obtained a total of 422 eligible responses. The adherence to best practices assessed was lower than the set threshold in all except one parameter in both teaching centers and non‐teaching centers. Only 58.5% of endoscopists had received training in the detection of PMUGIL. Appropriate image enhanced endoscopy (IEE) facilities were available to only 58.05% of surveyed endoscopists. Conclusions Strategies to improve detection of PMUGIL should be directed at improving adherence to best practices, ensuring adequate training of endoscopists in the evaluation of PMUGIL and improving infrastructure.
ISSN:0815-9319
1440-1746
DOI:10.1111/jgh.15983