Protocolized referral to endoscopy and Helicobacter pylori detected in stools aimed to decrease endoscopy waiting lists

LUIS COPPELLI; LUIS ANTONIO DÍAZ; ARNOLDO RIQUELME; CRISTIAN WAEGER; ANTONIO ROLLÁN; Enrique Bellolio; JUAN CARLOS ARAYA; MIGUEL ANGEL VILLASECA; MIGUEL VILLASMIL; GONZALO PÉREZ; CATALINA COPPELLI

Keywords: gastritis, atrophic, stomach neoplasms, Early detection of cancer, Endoscopy, gastrointestinal, Helicobacter pylory

Abstract

Background: Chile has one of the highest mortality rates by gastric cancer (GC) worldwide. Primary prevention of GC and detection of pre-neoplastic and early neoplastic lesions should be a national priority. Aim: To assess the impact of the protocolization of endoscopy referral and the use of H. pylori stool antigen test (HPSA) in the management of dyspepsia to decrease the waiting list for endoscopy and increase the detection of gastric pre-neoplastic and early neoplastic lesions. Material and Methods: We included all patients referred to the Endoscopy Unit of a regional hospital, from January 2015 to December 2017. We also included patients with known pre-neoplastic lesions and all those with first degree relatives with GC. We implemented protocols for referral of patients with dyspepsia considering the use of HPSA test, prioritizing to endoscopy those with a higher risk of GC. Results: A total of 4,641 endoscopies and 2,631 HPSA tests were carried out. After the adoption of these protocols, we observed a 52% decrease in the waiting time for endoscopy. The GC detection rate in this period was 1.8 to 3.1 cases per 100 endoscopies. After the adoption of the protocols, we observed a significant increase in early GC detection rate (from none in 2015 to 13% in 2017, p = 0.03). Conclusions: The protocolization of the referral for endoscopy associated with widespread use of HPSA test in the management of patients with dyspepsia, are successful strategies to decrease waiting lists for endoscopy and optimize the detection rate of pre-neoplastic lesions and early GC.

Más información

Título según WOS: Protocolized referral to endoscopy and Helicobacter pylori detected in stools aimed to decrease endoscopy waiting lists
Título según SCOPUS: Protocolized referral to endoscopy and Helicobacter pylori detected in stools aimed to decrease endoscopy waiting lists [La derivación protocolizada a endoscopía asociada a la detección de Helicobacter pylori mediante antígeno en deposiciones disminuye lista de espera para endoscopía y optimiza la detección de lesiones pre-malignas y cáncer gástrico incipiente]
Título según SCIELO: La derivación protocolizada a endoscopía asociada a la detección de Helicobacter pylori mediante antígeno en deposiciones disminuye lista de espera para endoscopía y optimiza la detección de lesiones pre-malignas y cáncer gástrico incipiente
Título de la Revista: REVISTA MEDICA DE CHILE
Volumen: 147
Número: 11
Editorial: Sociedad Médica de Santiago
Fecha de publicación: 2019
Página de inicio: 1382
Página final: 1389
Idioma: Spanish
DOI:

10.4067/s0034-98872019001101382

Notas: ISI, SCIELO, SCOPUS