| Abstract: | BACKGROUND & AIMS: The role of prior gastroscopy on outcome of gastric cancer patients remains unknown. This study determines the association between intervals of prior gastroscopy and mortality in patients with gastric cancer. METHODS: We identified 20,066 newly diagnosed gastric cancer patients in the national health insurance database of Taiwan between 2002 and 2007. After excluding gastroscopy performed 6 months before diagnosis of cancer, patients were matched into 3 cohorts according to the intervals of prior gastroscopy: 6 months to 2 years (<2Y cohort), 2 to 5 years (2-5Y cohort), and none within recent 5 years (>5Y cohort). The 3 cohorts were matched for age, curative treatment for gastric cancer, Helicobacter pylori therapy and propensity scores that comprised of gender, comorbidities and concomitant medication usage. The primary outcome is the hazard ratio (HR) of all-cause mortality. RESULTS: After matching, we identified 1,286, 1,286, and 5,144 patients for the <2Y, 2 to 5Y and >5Y cohorts. Compared with the >5Y cohort, the HR of all-cause mortality for the <2Y and 2 to 5Y cohorts was 0.80 (95% CI, 0.72-0.89; P<0.001) and 0.83 (95% CI, 0.76-0.91; P<0.001), respectively. The HRs of gastric cancer-specific mortality was also significantly lower in the <2Y (0.80; 95% CI, 0.71-0.91; P<0.001) and 2 to 5Y cohorts (0.83; 95% CI, 0.75-0.93; P<0.001). CONCLUSION: Gastric cancer patients who had gastroscopy performed within 5-year before cancer diagnosis have significantly lower mortality. Our results may support the role of repeat endoscopic examination or surveillance endoscopy in selected patients. |
