Verraraghavan Krishnamurthy, MD, DM1, Deepak Madhu, MD, MRCP, DM2, Thirumoorthi Natarajan, MD, DM1, Sundeep Lakhtakia, MD, DM3; 1Cancer Institute (WIA), Chennai, Tamil Nadu, India; 2Aster MIMS - Calicut, Calicut, Kerala, India; 3Asian Institute of Gastroenterology, AIG Hospitals, Hyderabad, Telangana, India
Introduction: Gastric and esophageal cancers are associated with the high morbidity and mortality in India. Detection of these cancers at an early stage can reduce the high morbidity. In the absence of formal population based screening for upper gastrointestinal cancers in India, it is important that all elective Esophago-Gastro-Duodenoscopies (EGDs), irrespective of the primary indication, be viewed as an opportunity to screen for pre-malignant lesions. With this premise, we aimed to assess the adherence to best practices with regard to detection of pre-malignant upper gastro-intestinal lesions (PMUGIL) among endoscopists in India. Methods: We conducted a cross-sectional survey among current practicing endoscopists in India using an online platform (SurveyMonkeyTM). The survey questionnaire contained 28 questions pertaining to demographic details, best practices (as defined by Asian Consensus on standards and ESGE guidelines for performance measures), training and facilities available to endoscopists. The survey link was circulated amongst GI endoscopists working in India through email and WhatsApp. The responses were collected from online submission to the survey link. The primary objectivewas to assess adherence to best practices regarding detection and characterization of PMUGILin India. An arbitrary threshold of 90% adherence was considered adequate. The secondary objectiveswere – assessment of the differences between teaching and non-teaching centers, adequacy of training, and availability of appropriate facilities with the endoscopists. Results: A total of 422 eligible responses were obtained. The adherence to best practices assessed were lower than the set threshold in all except one metric - the reporting of Barrett’s (Table 1) in both teaching centers and non-teaching centers. None of the respondents adhered to all the best practices surveyed. Among responding endoscopists, 58.5% (247/422) reported to having been trained in the detection of PMUGIL. Endoscopy equipment with facility of appropriate electronic Image Enhanced Endoscopy (IEE) for evaluating PMUGILwere available to 54.4% (223/410) of responding endoscopists. Discussion: Training interventions are necessary to improve practices in the evaluation of PMUGIL. Centers lacking appropriate IEE facilities should be encouraged to refer patients to appropriate centers for evaluation and follow up.
Disclosures: Verraraghavan Krishnamurthy indicated no relevant financial relationships. Deepak Madhu indicated no relevant financial relationships. Thirumoorthi Natarajan indicated no relevant financial relationships. Sundeep Lakhtakia indicated no relevant financial relationships.