Is Endoscopic Surveillance of Gastric Ulcers Overused?

Gastric ulcers, often caused by nonsteroidal anti-inflammatory drugs or Helicobacter pylori infection, are generally benign. However, because a small percentage of these ulcers are malignant, current guidelines recommend that all gastric ulcers be biopsied. Also, although the guidelines do not endorse the practice, many endoscopists use repeated endoscopy or biopsy of gastric ulcers to monitor healing and rule out malignancy, resulting in unnecessary surveillance endoscopies.

To assess the frequency of routine surveillance endoscopy of gastric ulcers, investigators in the U.S. queried the Clinical Outcomes Research Initiative (CORI) database, which includes data from more than 400 endoscopists in varied practice settings, to evaluate more th…