{
  "abstract": "Introduction Oesophageal strictures may represent benign or malignant pathology. We performed a population-based study to examine the proportion of people who had dilatation for stricture prior to a subsequent diagnosis of oesophageal cancer.Methods Oesophageal cancers diagnosed between 2018 and 2024 in England were analysed in national cancer registry data linked to Hospital Episode Statistics to identify patients who had dilatation up to 24 months before diagnosis. Multivariable logistic regression analysis examined associations with dilatation before cancer diagnosis.Results 56,827 patients with oesophageal cancer were studied. 1.2% had dilatation prior to cancer diagnosis (64% male, median age 74 (IQR 66-82)). Figure 1 illustrates the distribution of index dilatation in relation to cancer diagnosis date. Dilatation before cancer diagnosis was associated with women (odds ratio (OR) 1.19, 95% CI 1.01-1.41), squamous cell carcinoma (OR 1.54, 95% CI 1.28-1.86) and more comorbidity (Charlson score 5+ OR 3.69, 95% CI 2.59-5.26). Patients with prior dilatation were inversely associated with advanced stage cancer (stage 3 or 4) (OR 0.65, 95% CI 0.53-0.79). However, this was only inversely associated when patients had endoscopic follow-up post-dilatation (OR 0.5, 95% CI 0.33-0.75). Overall, 3.9% of dilated patients had a perforation. This risk was higher among women (OR 2.58, 95% CI 1.18-5.65) and those who had 4 or more dilatations (OR 4.03, 95% CI 1.47-11.08).Conclusions Approximately 1 in 80 oesophageal cancers had dilatation prior to diagnosis, with a significant perforation risk. In 36.4%, dilatation was over 3 months prior to cancer diagnosis, suggesting missed opportunities for earlier diagnosis. Dilatation prior to diagnosis was associated with squamous cell carcinoma, highlighting that endoscopists particularly fail to recognise this cancer.Abstract FP35 Figure 1Time from first oesophageal dilatation to cancer diagnosis. (A) Histogram of the time periods patients underwent their first oesophageal dilatation prior to cancer diagnosis. (B) Cumulative proportion of dilatations over time preceding diagnosis",
  "authors": [
    {
      "affiliations": [
        "Sandwell and West Birmingham NHS Trust, West Bromwich, United Kingdom",
        "University of Birmingham, Birmingham, United Kingdom",
        "The Royal College of Surgeons of England, London, United Kingdom"
      ],
      "name": "Amar Srinivasa"
    },
    {
      "affiliations": [
        "The Royal College of Surgeons of England, London, United Kingdom"
      ],
      "name": "Amanda McDonell"
    },
    {
      "affiliations": [
        "The Royal College of Surgeons of England, London, United Kingdom",
        "London School of Hygiene & Tropical Medicine, London, United Kingdom"
      ],
      "name": "Min Hae Park"
    },
    {
      "affiliations": [
        "Velindre Cancer Centre, Cardiff, United Kingdom"
      ],
      "name": "Tom Crosby"
    },
    {
      "affiliations": [
        "Guy’s and St Thomas’ Hospital NHS Foundation Trust, London, United Kingdom"
      ],
      "name": "James Gossage"
    },
    {
      "affiliations": [
        "The Royal College of Surgeons of England, London, United Kingdom",
        "London School of Hygiene & Tropical Medicine, London, United Kingdom"
      ],
      "name": "David Cromwell"
    },
    {
      "affiliations": [
        "Sandwell and West Birmingham NHS Trust, West Bromwich, United Kingdom",
        "University of Birmingham, Birmingham, United Kingdom",
        "The Royal College of Surgeons of England, London, United Kingdom"
      ],
      "name": "Nigel Trudgill"
    }
  ],
  "title": "FP35 Prevalence and outcomes of oesophageal dilatation prior to cancer diagnosis: analysis of 57,511 patients with oesophageal cancer in England",
  "uid": "265461b7-d31b-53dc-bc3f-8b6ff3024968"
}