HIGH RISK FACTORS FOR UPPER GASTROINTESTINAL MALIGNANCY AMONG PATIENTS PRESENTING WITH DYSPHAGIA: ANALYSIS OF PATIENTS WHO PRESENTED TWO TERTIARY CARE CENTERS IN DIFFERENT GEOGRAPHICAL LOCATIONS IN SRI LANKA
Chathuranga T. Keppetiyagama*, Nadeesha J. Nawarathna, Amal priyantha
Gastroeneterological Surgery, Teaching Hospital Kandy, Sri Lanka, Galle, Southern Province, Sri Lanka
Introductions: Dysphagia is considered an alarm symptom and usually requires Endoscopy. However not all patients with dysphagia harbor malignancy. This study evaluates the other co-founding factors that may predict malignancy in Sri Lankan patients presenting with dysphagia.
Methods: This is a retrospective descriptive study. Data from adult patients who underwent upper gastrointestinal endoscopy for dysphagia from January 2017 to July 2018 in two tertiary referral centers (Kandy and Kalubowila) were analyzed.
Results: Out of 306 patients with dysphagia 61(19.9%) had malignancy. Patient with malignancy had a higher mean age (65 ± 12.6 vs. 60 ± 14.1 years) and a shorter duration of dysphagia (12 ± 7 vs. 28 ± 25 weeks). Pearson's Chi-Squared test revealed that presence of malignancy associated with gender (8.94, p = 0.003) and location (17.02, p < 0.05). According to logistic regression patients age (p=0.018), gender (p=0.022) and location (p<0.05) were statistically significant in predicting the presence of a tumor. Odds of having malignancy increased by 2.8% for each year of increase in age. Male have 2 times (95% CI; 1.105 to 3.672) higher odds of having a tumor compared to females (p=0.034) controlling for age and location. Kandy location have a 3 times (95% CI; 0.175 to 0.575) higher odds of having a tumor compared to Kalubowila (p=0.000) controlling for age and gender.
Conclusion: Male gender, advance age and Kandy location are high risk factors. Other significant predictors of malignancy in patients with dysphagia need to be assessed with a larger sample size.
Keywords: Dysphagia, Malignancy.
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