Predictive value of alarm features in diagnosing upper gastrointestinal malignancies among dyspeptic patients: A cross-sectional study in Ethiopia

Wudassie Melak¹,
Wassihun Asmare^2,*,
Abate Bane¹ and
Mengistu Erkie¹

Gastroenterology & Hepatology Research 2023;5(3):13

doi: 10.53388/ghr2023-03-077

Published online: September 18, 2023

Author information

Citation: Melak W, Asmare W, Bane A, Erkie M. Predictive value of alarm features in diagnosing upper gastrointestinal malignancies among dyspeptic patients: A cross-sectional study in Ethiopia. Gastroenterol & Hepatol Res. 2023;5(3):13. doi: 10.53388/ghr2023-03-077.

Abstract

Objective

The study aimed to determine the overall predictive value of alarm features in diagnosing upper Gastrointestinal (GI) malignancies and significant endoscopic findings among patients undergoing elective Esophagogastroduodenoscopy (EGD) at Tikur Anbessa Special Hospital (TASH) and Adera Medical Centre (AMC).

Methods

It was an institution-based cross-sectional study conducted on patients undergoing elective endoscopy for an upper GI complaint from July to September 2022. Data was collected from patient charts, and biopsies were taken for histologic confirmation. The study assessed the association of alarm symptoms and signs with significant upper gastrointestinal (UGI) endoscopic findings and malignancies.

Results

142 patients were selected, with an average age of 48.35 and 52.1% being male. Epigastric pain was the most common reason for an endoscopy. 62% of patients had at least one alarm feature, the most common being unexplained weight loss and UGI bleeding. The study found a strong association between the presence of alarm features, significant endoscopic findings, and UGI malignancies. The pooled sensitivity and specificity of any alarm feature for any significant finding were 79% and 64.9%, respectively, and for malignancy, 100% and 39.7%, respectively. The presence of the alarm feature was associated with an increase of 6.801 in the odds of developing SEF and an increase of 4.199 in the odds of developing malignancy.

Conclusions

UGI alarm symptoms and signs like an abdominal mass, persistent vomiting, dysphagia, and UGI bleeding are predictive of significant endoscopic findings and malignancies. Hence, EGD should be done and suspicious lesions should be biopsied early, regardless of gender, age, or duration of symptoms.

Keywords

alarm symptoms, dyspepsia, endoscopy, gastric cancer, PUD, esophageal cancer

Copyright © 2025 Authors. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 License (CC BY-NC 4.0), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Melak W, Asmare W, Bane A, Erkie M. Predictive value of alarm features in diagnosing upper gastrointestinal malignancies among dyspeptic patients: A cross-sectional study in Ethiopia. Gastroenterol & Hepatol Res. 2023;5(3):13. doi: 10.53388/ghr2023-03-077.

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Article History

Received	Revised	Accepted	Published
			September 18, 2023

DOI http://dx.doi.org/10.53388/ghr2023-03-077

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