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Study findings from Europe and North America support recommended initial treatment of dyspepsia with testing for Helicobacter pylori and treating infection if found; endoscopy is recommended in patients who are elderly or have alarm symptoms (Gastroenterology 2005; 129:1756 and Am J Gastroenterol 2005; 100:2324). In the current meta-analysis, investigators assessed the value of prompt endoscopy in initial evaluation of dyspepsia in Asia, where gastric cancer rates are higher.
A broad literature search produced 18 studies meeting the inclusion criteria and addressing detection rates (15) and the predictive value of alarm features (6) and age (5). The malignancy detection rate was 1.30% (0.80%–2.10%) — higher than that seen in Western studies.…