ArticlePloS one2012
Diagnostic accuracy of age and alarm symptoms for upper GI malignancy in patients with dyspepsia in a GI clinic: a 7-year cross-sectional study.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 4 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Diagnostic Risk Prediction Models for Upper Gastrointestinal Cancers: A Systematic Review.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Pooled it
- Prevalence of tobacco use among cancer patients in Iran: a systematic review and meta-analysis.BMC public health · 2024Pooled it
- Cancer diagnostic tools to aid decision-making in primary care: mixed-methods systematic reviews and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2020Pooled it
- Definition of "persistent vomiting" in current medical literature: A systematic review.Medicine · 2017Pooled it
- Cancer risk in patients with recurrent or persistent symptoms: a systematic review.The Lancet regional health. Europe · 2026Review
- Endoscopic findings in patients with chronic bloating/abdominal distension and the effect of the transition from the Rome III to Rome IV criteria: a multicenter cross-sectional study.BMC gastroenterology · 2026Article
- Endoscopic Findings in Patients Presenting Dyspepsia: A Population-Based Study in Mashhad, North East of Iran.Middle East journal of digestive diseases · 2025Article
- Epidemiology, Causes, and Management of Gastro-esophageal Reflux Disease: A Systematic Review.Cureus · 2023Review
- The risk of unexpected hospital admissions and primary care visits after an elective day-case gastroscopy: a cohort study within England.Alimentary pharmacology & therapeutics · 2022Article
- Article
- Diagnostic utility of alarm features in predicting malignancy in patients with dyspeptic symptoms.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2021Observational
- A Simple Pre-endoscopy Score for Predicting Risk of Malignancy in Patients with Dyspepsia: A 5-Year Prospective Study.Digestive diseases and sciences · 2018Article
- The diagnostic yield of open-access endoscopy of the upper gastrointestinal tract in the Netherlands.Endoscopy international open · 2018Article
- Reassessing the value of gastroscopy for the investigation of dyspepsia.Frontline gastroenterology · 2018Article
- The National Oesophagogastric Cancer Awareness Campaign: a locality outcome analysis from County Durham.Frontline gastroenterology · 2017Article
- Diagnostic value of alarm symptoms for upper GI malignancy in patients referred to GI clinic: A 7 years cross sectional study.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2017Article
- Diagnostic yield of endoscopy in patients with abdominal complaints: incremental value of faecal calprotectin on guidelines of appropriateness.BMC gastroenterology · 2014Article
- Endoscopic findings in uninvestigated dyspepsia.BMC gastroenterology · 2014Observational
- Current management strategies and emerging treatments for functional dyspepsia.Nature reviews. Gastroenterology & hepatology · 2013Review
- Gastroesophageal Reflux Disease (GERD).Missouri medicineReview
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe investigated whether using demographic characteristics and alarm symptoms can accurately predict cancer in patients with dyspepsia in Iran, where upper GI cancers and H. pylori infection are common.
methodsAll consecutive patients referred to a tertiary gastroenterology clinic in Tehran, Iran, from 2002 to 2009 were invited to participate in this study. Each patient completed a standard questionnaire and underwent upper gastrointestinal endoscopy. Alarm symptoms included in the questionnaire were weight loss, dysphagia, GI bleeding, and persistent vomiting. We used logistic regression models to estimate the diagnostic value of each variable in combination with other ones, and to develop a risk-prediction model.
resultsA total of 2,847 patients with dyspepsia participated in this study, of whom 87 (3.1%) had upper GI malignancy. Patients reporting at least one of the alarm symptoms constituted 66.7% of cancer patients compared to 38.9% in patients without cancer (p<0.001). Esophageal or gastric cancers in patients with dyspepsia was associated with older age, being male, and symptoms of weight loss and vomiting. Each single predictor had low sensitivity and specificity. Using a combination of age, alarm symptoms, and smoking, we built a risk-prediction model that distinguished between high-risk and low-risk individuals with an area under the ROC curve of 0.85 and acceptable calibration.
conclusionsNone of the predictors demonstrated high diagnostic accuracy. While our risk-prediction model had reasonable accuracy, some cancer cases would have remained undiagnosed. Therefore, where available, low cost endoscopy may be preferable for dyspeptic older patient or those with history of weight loss.
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