Predictive effect of heartburn and indigestion and risk of upper gastro-intestinal malignancy

摘要

Further to our recent publication of two papers in the BJGP,1,2 we have been asked to evaluate specifically whether dyspepsia is a significant independent predictor of upper gastro-intestinal malignancy (in other words, gastro-oesophageal and pancreatic malignancy) and to consider adding it to the models. These symptoms (heartburn or indigestion) were not included in the original analysis that had focused on more traditional alarm symptoms. We, therefore, undertook an analysis based on the original derivation cohort from the published studies and identified patients with new onset of (a) heartburn or (b) indigestion (other than where heartburn is explicitly mentioned). We determined the age–sex incidence rates. We added both factors to the Cox models and determined the hazard ratios adjusted for the factors in the original models. We tested for interactions between the new variables and age. We evaluated performance of the new models on the original validation dataset using published methods.