Age threshold for endoscopy and risk of missing upper gastrointestinal malignancy - data from the Scottish audit of gastric and oesophageal cancer

SUMMARY Background Urgent endoscopy is indicated for suspected upper gastrointestinal malignancy. However, there is limited evidence on the age threshold for performing urgent endoscopy in uncomplicated dyspepsia (that is, without alarm features). Aim To quantify the risk of missing upper gastrointestinal malignancy within Scotland, if the age threshold for urgent endoscopy in uncomplicated dyspepsia was increased from 45 to 55 years. Methods Analysis of data collected prospectively by the Scottish Audit of Gastric and Oesophageal Cancer. ‘Alarm’ features at presentation were defined as dysphagia, weight loss, gastrointestinal bleeding, anaemia, vomiting, history of gastric surgery and history of peptic ulcer disease. Results