{
  "abstract": "Objective Follow-up oesophago-gastroduodenoscopy (OGD) is recommended after diagnosing oesophageal ulcer or severe oesophagitis. We aimed to examine the yield of a follow-up OGD to identify oesophageal cancer or dysplasia and their predictors.Method In this retrospective cohort study, we collected demographic, endoscopy, histology and follow-up data from 771 patients diagnosed with oesophageal ulcer or severe oesophagitis. We examined the proportion of patients diagnosed with cancer or dysplasia at follow-up. Cost and carbon footprint of follow-up OGDs were estimated.Results The yield of cancer at follow-up was 0.40% and the yield of cancer or dysplasia 0.81%. Those who were diagnosed with oesophageal cancer or dysplasia, compared with those who were not, were older (mean age 71.9 (SD 9.9) vs 64.9 (SD 16.7), p<0.001), more likely to have ulcers ≥10 mm (68.2% vs 3.0% p<0.001), endoscopic features suspicious for malignancy (62.2% vs 4.6%, p<0.001), Barrett’s oesophagus (54.1% vs 10.2%, p<0.001) and have biopsies taken at index OGD (97.3% vs 52.5%, p<0.001). Following logistic regression, those with endoscopic features of cancer (OR=27.8; 95% CI 7.74 to 99.6) and those with associated Barrett’s oesophagus identified at the index OGD (OR=7.91; 95% CI 2.44 to 25.6) were more likely to be diagnosed with cancer or dysplasia. Estimated cost for follow-up OGDs was £356 850 and the estimated carbon footprint was 21 056 kg of CO 2 equivalent.Conclusion The yield of cancer or dysplasia at follow-up is low, suggesting that current guideline recommendations should be reconsidered.",
  "authors": [
    {
      "affiliations": [
        "Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK"
      ],
      "name": "Rebecca Osborne"
    },
    {
      "affiliations": [
        "Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK"
      ],
      "name": "Miren Elphick"
    },
    {
      "affiliations": [
        "Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK"
      ],
      "name": "Harun Ibrahim"
    },
    {
      "affiliations": [
        "Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK"
      ],
      "name": "Matthew White"
    },
    {
      "affiliations": [
        "Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK",
        "Leeds Institute of Medical Research at St. James’s, University of Leeds Faculty of Medicine and Health, Leeds, UK"
      ],
      "name": "Chun Sin"
    },
    {
      "affiliations": [
        "Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK"
      ],
      "name": "Thomas Archer"
    },
    {
      "affiliations": [
        "Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK",
        "Leeds Institute of Medical Research at St. James’s, University of Leeds Faculty of Medicine and Health, Leeds, UK"
      ],
      "name": "Conchubhair Winters"
    },
    {
      "affiliations": [
        "Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK",
        "Leeds Institute of Medical Research at St. James’s, University of Leeds Faculty of Medicine and Health, Leeds, UK"
      ],
      "name": "Noor Mohammed"
    },
    {
      "affiliations": [
        "Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK"
      ],
      "name": "Bjorn J Rembacken"
    },
    {
      "affiliations": [
        "Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK",
        "Leeds Institute of Medical Research at St. James’s, University of Leeds Faculty of Medicine and Health, Leeds, UK"
      ],
      "name": "Vivek C Goodoory"
    },
    {
      "affiliations": [
        "Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK",
        "Leeds Institute of Medical Research at St. James’s, University of Leeds Faculty of Medicine and Health, Leeds, UK"
      ],
      "name": "Ruchit Sood"
    }
  ],
  "title": "Utility of a follow-up endoscopy after a diagnosis of severe oesophagitis or oesophageal ulcer and predictors of cancer and dysplasia",
  "uid": "b6a2cbaf-212a-5856-ac9f-bb3a24206a5a"
}