Changes in Time in Yield of Upper Gastrointestinal Endoscopy in Relation to the Applicants Speciality

Abstract

Introduction: The diagnostic yield of upper gastrointestinal endoscopy (UGE) is high. Aim: A study was done in order to relate the outcome of UGE to the speciality of the applicant and to study changes in yield in a long period of time. Material and Methods: A large dataset was used. The endoscopic diagnoses were noted as a percentage of the yearly procedures done on request of the specific applicant. The following endoscopic diagnoses were primarily scored: reflux oesophagitis, peptic ulcer disease, hiatal hernia or insufficient gastric cardia, and cancer. Results: A total of 36650 procedures were studied via the general practitioner (GP) in 14913 cases (40.6%), the gastroenterologist in 6993 (19%), surgeon or cardiologist in 496 (1.4%) and in 14248 cases (38.9%) via the internist. No abnormalities and reflux oesophagitis were significantly more often scored in cases done on request of the GP. Cancer was more often seen in cases with the gastroenterologist as the applicant. After an initial rise incidence of hiatal hernia, insufficient cardia, and reflux oesophagitis, both findings show a decrease since 2007. There is some yearly fluctuation in presence of reflux-oesophagitis and cancer, while peptic ulcer disease decreases. Conclusion: The general yield of UGE is relatively high. There are differences in outcome if the applicant is taken into account. It is also clear that gastro-oesophageal reflux disease is a condition mostly treated by general practitioners.