Title: Esophageal cancers missed at upper endoscopy in Central Norway 2004 to 2021 – A
population based study
Version: 2 Date: 13 Jun 2024
Reviewer's report:
This manuscript aimed to evaluate the incidence rate of missed esophageal cancer (MEC) and
identify risk factors for this missed diagnosis of esophageal cancer by using Cancer Registry
of Norway. The authors evaluated 625 patients with esophageal cancer and found the missed
diagnosed rate was 8.2%. The missed esophageal cancers were usually found in patients with
Barrett’s esophagus, hiatus hernia, esophagitis and ulceration and careful inspection in these
patients should be considered to decrease the missed rate.
Some suggestions were listed below.
1. In Table 2, the variable should be compared between initial negative endoscopy in MEC
patients (n=51) and diagnostic endoscopy in control (n=574), such as table 1, and it makes more
sense.
2. Patients with dysplasia (n=10, table 2) should be excluded from analysis because planned
repeat endoscopies are usually arranged for these patients.
3. The information of cancer stage (TNM) should be provided in manuscript, as authors
mentioned TNM classification evolved from AJCC 6 to AJCC 8 was a limitation (discussion).
Title: Esophageal cancers missed at upper endoscopy in Central Norway 2004 to 2021 – A
population based study
Version: 2 Date: 13 Jun 2024
Reviewer's report:
This manuscript aimed to evaluate the incidence rate of missed esophageal cancer (MEC) and
identify risk factors for this missed diagnosis of esophageal cancer by using Cancer Registry
of Norway. The authors evaluated 625 patients with esophageal cancer and found the missed
diagnosed rate was 8.2%. The missed esophageal cancers were usually found in patients with
Barrett’s esophagus, hiatus hernia, esophagitis and ulceration and careful inspection in these
patients should be considered to decrease the missed rate.
Some suggestions were listed below.
1. In Table 2, the variable should be compared between initial negative endoscopy in MEC
patients (n=51) and diagnostic endoscopy in control (n=574), such as table 1, and it makes more
sense.
2. Patients with dysplasia (n=10, table 2) should be excluded from analysis because planned
repeat endoscopies are usually arranged for these patients.
3. The information of cancer stage (TNM) should be provided in manuscript, as authors
mentioned TNM classification evolved from AJCC 6 to AJCC 8 was a limitation (discussion).
Please review this paper.
user
Title: Esophageal cancers missed at upper endoscopy in Central Norway 2004 to 2021 – A
population based study
Version: 2 Date: 13 Jun 2024
Reviewer's report:
This manuscript aimed to evaluate the incidence rate of missed esophageal cancer (MEC) and
identify risk factors for this missed diagnosis of esophageal cancer by using Cancer Registry
of Norway. The authors evaluated 625 patients with esophageal cancer and found the missed
diagnosed rate was 8.2%. The missed esophageal cancers were usually found in patients with
Barrett’s esophagus, hiatus hernia, esophagitis and ulceration and careful inspection in these
patients should be considered to decrease the missed rate.
Some suggestions were listed below.
1. In Table 2, the variable should be compared between initial negative endoscopy in MEC
patients (n=51) and diagnostic endoscopy in control (n=574), such as table 1, and it makes more
sense.
2. Patients with dysplasia (n=10, table 2) should be excluded from analysis because planned
repeat endoscopies are usually arranged for these patients.
3. The information of cancer stage (TNM) should be provided in manuscript, as authors
mentioned TNM classification evolved from AJCC 6 to AJCC 8 was a limitation (discussion).
assistant