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The value of early endoscopy for evaluating patients with dyspepsia remains a subject of debate, and practice guidelines differ on the recommended timing of endoscopy in older patients. To clarify this area of clinical practice, investigators prospectively studied 2741 outpatients who each met Rome II criteria for dyspepsia, did not have alarm symptoms, and underwent endoscopy at 1 of 190 primary healthcare centers in 17 countries.
Endoscopy identified only six cancers (3 esophageal and 3 gastric) in the cohort (prevalence, 0.2%); only one cancer was in a patient younger than 50. Mucosal abnormalities were identified in 23.2% of the cohort, including erosive esophagitis in 14.8%, duodenal ulcers in 2.7%, and gastric ulcers in 2.3%. Using the…