Examination time as a quality indicator of screening upper gastrointestinal endoscopy for asymptomatic examinees

Background and aim The significance of examination time of esophagogastroduodenoscopy (EGD) for asymptomatic examinees is yet to be established. We aimed to clarify whether endoscopists who allot more examination time can detect higher numbers of neoplastic lesions among asymptomatic examinees. Methods We reviewed a database of consecutive examinees who underwent EGD in our hospital from April 2010 to September 2015. Staff endoscopists were classified into fast, moderate, and slow groups based on the mean examination time of EGD without a biopsy. The neoplastic lesion detection rate among these groups was compared using multiple logistic regression. Results Of the 55,786 consecutive examinees who underwent EGD, 15,763 asymptomatic examinees who were screened by staff doctors were analyzed. The mean examination time of 13,661 EGDs without biopsy was 6.2 min (range, 2–18 min). When cutoffs of 5 and 7 min were used, 4 endoscopists were classified into the fast (mean duration, 4.4 ± 1.0 min), 12 into the moderate (6.1 ± 1.4 min), and 4 into the slow groups (7.8 ± 1.9 min). The neoplastic lesion detection rates in the fast, moderate, and slow groups were 0.57% (13/2,288), 0.97% (99/10,180), and 0.94% (31/3,295), respectively. Compared with that in the fast group, the odds ratios for the neoplastic lesion detection rate in the moderate and slow groups were 1.90 (95% confidence interval [CI], 1.06–3.40) and 1.89 (95% CI, 0.98–3.64), respectively. Conclusion Endoscopists who do not allot adequate examination time may overlook neoplastic lesions in the upper gastrointestinal tract. This article is protected by copyright. All rights reserved.