Diagnostic Yield of Opportunistic Upper Gastrointestinal Endoscopy During Elective Colonoscopy in Asymptomatic Patients: A Retrospective Cross-Sectional Study.
4 affiliations
- 1Endoscopy Division, Rede Mater Dei de Saúde, Belo Horizonte, BRA.
- 2Gastroenterology Division, Rede Mater Dei de Saúde, Belo Horizonte, BRA.
- 3Endoscopy Division, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, BRA.
- 4Endoscopy Division, Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, BRA.
Abstract
Background Opportunistic upper gastrointestinal endoscopy (EGD) during elective colonoscopy has been proposed as a strategy for detecting upper gastrointestinal abnormalities in asymptomatic individuals. However, evidence regarding its diagnostic yield and clinical relevance remains limited, particularly in Western populations. This study aimed to evaluate the diagnostic yield of opportunistic EGD performed during elective colonoscopy in asymptomatic patients. Methods This retrospective cross-sectional study included asymptomatic patients who underwent opportunistic EGD during elective colonoscopy at a tertiary endoscopy center in Brazil between March 2023 and March 2025. The primary outcome was the proportion of patients with at least one clinically significant finding, including selected premalignant and malignant lesions, Helicobacter pylori (H. pylori) infection, and other potentially relevant upper gastrointestinal abnormalities. Endoscopic and histopathological findings were retrospectively reviewed. Descriptive statistical analyses were performed, and diagnostic yield was reported with a 95% confidence interval (CI). Changes in clinical management were not assessed. Results A total of 421 asymptomatic patients were included, of whom 269 (63.9%) were female; the mean age was 58.4 years. At least one clinically significant finding was identified in 188 patients (44.7%; 95% CI: 39.8%-49.5%). Gastritis was identified in 293 patients (69.6%), and H. pylori infection was detected in 102 (24.2%). Premalignant gastric findings included intestinal metaplasia in 45 patients (10.7%), gastric atrophy in 27 (6.4%), and low-grade dysplasia in 2 (0.5%). Gastric carcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma were each diagnosed in one patient (0.2%). Additional findings included gastric polyps in 140 patients (33.3%), esophagitis in 134 (31.8%), bulboduodenitis in 26 (6.2%), and Barrett's esophagus in 3 (0.7%). Conclusions Opportunistic EGD performed during elective colonoscopy demonstrated a substantial diagnostic yield in asymptomatic patients, including the detection of premalignant and malignant upper gastrointestinal lesions. However, the absence of systematic follow-up and a comparison group precludes conclusions regarding actual changes in clinical management or improvements in patient outcomes. Prospective comparative studies incorporating longitudinal follow-up, procedural safety, and economic evaluation are needed to determine the clinical value of this strategy.
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BibTeX
@article{freitas2026diagnostic,
title = {{Diagnostic Yield of Opportunistic Upper Gastrointestinal Endoscopy During Elective Colonoscopy in Asymptomatic Patients: A Retrospective Cross-Sectional Study.}},
author = {Caroline Assis Aleixo Chaves Freitas and Sandro Rodrigues Chaves and Rafael P Pessoa and Lucas Gallo de Alvarenga Mafra and Júlia Gallo de Alvarenga Mafra and Eduardo Seubert Coelho Vieira and Gabriela Vieira Brito and Giovanna De Giuli and Rodrigo Roda},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.118181},
url = {https://europepmc.org/article/MED/42923068},
note = {CC BY},
}
RIS
TY - JOUR
TI - Diagnostic Yield of Opportunistic Upper Gastrointestinal Endoscopy During Elective Colonoscopy in Asymptomatic Patients: A Retrospective Cross-Sectional Study.
AU - Caroline Assis Aleixo Chaves Freitas
AU - Sandro Rodrigues Chaves
AU - Rafael P Pessoa
AU - Lucas Gallo de Alvarenga Mafra
AU - Júlia Gallo de Alvarenga Mafra
AU - Eduardo Seubert Coelho Vieira
AU - Gabriela Vieira Brito
AU - Giovanna De Giuli
AU - Rodrigo Roda
PY - 2026
DA - 2026/10/19
JO - Cureus
DO - 10.7759/cureus.118181
UR - https://europepmc.org/article/MED/42923068
AB - Background Opportunistic upper gastrointestinal endoscopy (EGD) during elective colonoscopy has been proposed as a strategy for detecting upper gastrointestinal abnormalities in asymptomatic individuals. However, evidence regarding its diagnostic yield and clinical relevance remains limited, particularly in Western populations. This study aimed to evaluate the diagnostic yield of opportunistic EGD performed during elective colonoscopy in asymptomatic patients. Methods This retrospective cross-sectional study included asymptomatic patients who underwent opportunistic EGD during elective colonoscopy at a tertiary endoscopy center in Brazil between March 2023 and March 2025. The primary outcome was the proportion of patients with at least one clinically significant finding, including selected premalignant and malignant lesions, Helicobacter pylori (H. pylori) infection, and other potentially relevant upper gastrointestinal abnormalities. Endoscopic and histopathological findings were retrospectively reviewed. Descriptive statistical analyses were performed, and diagnostic yield was reported with a 95% confidence interval (CI). Changes in clinical management were not assessed. Results A total of 421 asymptomatic patients were included, of whom 269 (63.9%) were female; the mean age was 58.4 years. At least one clinically significant finding was identified in 188 patients (44.7%; 95% CI: 39.8%-49.5%). Gastritis was identified in 293 patients (69.6%), and H. pylori infection was detected in 102 (24.2%). Premalignant gastric findings included intestinal metaplasia in 45 patients (10.7%), gastric atrophy in 27 (6.4%), and low-grade dysplasia in 2 (0.5%). Gastric carcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma were each diagnosed in one patient (0.2%). Additional findings included gastric polyps in 140 patients (33.3%), esophagitis in 134 (31.8%), bulboduodenitis in 26 (6.2%), and Barrett's esophagus in 3 (0.7%). Conclusions Opportunistic EGD performed during elective colonoscopy demonstrated a substantial diagnostic yield in asymptomatic patients, including the detection of premalignant and malignant upper gastrointestinal lesions. However, the absence of systematic follow-up and a comparison group precludes conclusions regarding actual changes in clinical management or improvements in patient outcomes. Prospective comparative studies incorporating longitudinal follow-up, procedural safety, and economic evaluation are needed to determine the clinical value of this strategy.
SN - 2168-8184
ER -