{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T23:52:27Z","timestamp":1788565947240,"version":"build-2803163510"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T00:00:00Z","timestamp":1611532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002A structured assessment of the oropharynx, hypopharynx and larynx (OHL) may improve the diagnostic yield for the detection of precancerous and early cancerous lesions (PECLs) during routine esophagogastroduodenoscopy (EGD). Thus, we aimed to compare routine EGDs \u00b1 structured OHL assessment (SOHLA), including photo documentation with regard to the detection of PECLs.<\/jats:p><jats:p>\n          Patients and methods\u2002Consecutive patients with elective EGD were arbitrarily allocated to endoscopy lists with or without SOHLA. All detected OHL abnormalities were assessed by an otolaryngologist-head &amp; neck surgeon (ORL-HNS) and the frequency of PECLS detected during SOHLA vs. standard cohort compared.<\/jats:p><jats:p>\n          Results\u2002Data from 1000 EGDs with and 1000 EGDs without SOHLA were analyzed. SOHLA was successful in 93.3\u200a% of patients, with a median assessment time of 45 seconds (interquartile range: 40\u201350). SOHLA identified 46 potential PECLs, including two benign subepithelial lesions (4.6\u200a%, 95\u200a% CI: 3.4\u20136.1) while without SOHLA, no malignant and only one benign lesion was found (P\u200a&lt;\u200a0.05). ORL-HNS imaging review classified 23 lesions (2.3\u200a%, 95\u200a% CI: 1.5\u20133.4) as concerning and ORL-HNS clinic assessment was arranged. This identified six PECLs (0.6\u200a%, 95\u200a% CI: 0.2\u20131.3) including two pharyngeal squamous cell lesions (0.2\u200a%) demonstrating high-grade dysplasia and carcinoma in situ (CIS) and four premalignant glottic lesions (0.4\u200a%) demonstrating low-grade dysplasia and CIS.<\/jats:p><jats:p>\n          Conclusion\u2002In the routine setting of a gastrointestinal endoscopy practice precancerous and early cancerous lesions of the oropharynx, hypopharynx, and larynx are rare (&lt;\u200a1\u200a%) but can be detected with a structured assessment of this region during routine upper gastrointestinal endoscopy.<\/jats:p>","DOI":"10.1055\/a-1311-1014","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T23:33:49Z","timestamp":1611617629000},"page":"E154-E162","source":"Crossref","is-referenced-by-count":8,"title":["Structured oropharynx, hypopharynx and larynx assessment during routine esophagogastroduodenoscopy improves detection of pre- and early cancerous lesions: a multicenter, comparative study"],"prefix":"10.1055","volume":"09","author":[{"given":"Alexander","family":"Huelsen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"St John","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratna","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, North Shore Hospital, Waitemata District Health Board, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Vokes","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head & Neck Surgery, Auckland City Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica J.","family":"McMaster","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia"},{"name":"Translational Research Institute, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell S.","family":"Walmsley","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, North Shore Hospital, Waitemata District Health Board, Auckland, New Zealand"},{"name":"Faculty of Medicine, University of Auckland, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald J.","family":"Holtmann","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia"},{"name":"Translational Research Institute, Brisbane, Queensland, Australia"},{"name":"Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"key":"ref1","volume-title":"Australian Institute of Health and Welfare. Cancer data in Australia","author":"AIHW","year":"2019"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"2130","DOI":"10.1016\/j.ejca.2015.07.043","article-title":"Prognoses and improvement for head and neck cancers diagnosed in Europe in early 2000s: The EUROCARE-5 population-based study","volume":"51","author":"G Gatta","year":"2015","journal-title":"Eur J Cancer"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21590","article-title":"Cancer statistics, 2020","volume":"70","author":"R L Siegel","year":"2020","journal-title":"CA Cancer J Clin"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1136\/gutjnl-2018-317111","article-title":"An Asian consensus on standards of diagnostic upper endoscopy for neoplasia","volume":"68","author":"P WY Chiu","year":"2019","journal-title":"Gut"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1017\/S0022215115003084","article-title":"Conceiving a national head and neck cancer screening programme","volume":"130","author":"D S Gogarty","year":"2016","journal-title":"J Laryngol Otol"},{"key":"ref7","volume-title":"Oral Cavity, Pharyngeal, and Laryngeal Cancer Screening (PDQ(R)): Health Professional Version","author":"Screening PDQ, Prevention Editorial B","year":"2002"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1016\/j.oraloncology.2013.09.007","article-title":"Outcomes of a head and neck cancer screening clinic","volume":"49","author":"A G Shuman","year":"2013","journal-title":"Oral Oncol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1007\/s00405-014-3030-6","article-title":"Prognostic factors of quality of life after transoral laser microsurgery for laryngeal cancer","volume":"272","author":"I Vilaseca","year":"2015","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"ref11","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-40618-3","volume-title":"AJCC Cancer Staging Manual (8th edition)","author":"M BES Amin","year":"2017"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.oraloncology.2018.06.009","article-title":"Utilization of transoral robotic surgery (TORS) in patients with oropharyngeal squamous cell carcinoma and its impact on survival and use of chemotherapy","volume":"86","author":"S Baliga","year":"2018","journal-title":"Oral Oncol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"S90","DOI":"10.1017\/s0022215116000505","article-title":"Oropharyngeal cancer: United Kingdom National Multidisciplinary Guidelines","volume":"130","author":"H Mehanna","year":"2016","journal-title":"J Laryngol Otol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"2071","DOI":"10.1007\/s00405-018-5027-z","article-title":"Oncological and functional outcomes of transoral laser surgery for laryngeal carcinoma","volume":"275","author":"D Pedregal-Mallo","year":"2018","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1001\/jama.1977.03270290020014","article-title":"\u201cLight up the larynx\u201d during upper gastrointestinal endoscopy","volume":"237","author":"R G Norfleet","year":"1977","journal-title":"JAMA"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.dld.2008.06.015","article-title":"Should inspection of the laryngopharyngeal area be part of routine upper gastrointestinal endoscopy? A prospective study","volume":"41","author":"P Katsinelos","year":"2009","journal-title":"Digest Liver Dis"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/S0016-5107(85)72182-7","article-title":"Evaluation of the larynx, hypopharynx, and nasopharynx at the time of diagnostic upper gastrointestinal endoscopy","volume":"31","author":"R A Kozarek","year":"1985","journal-title":"Gastrointest Endosc"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/S0016-5107(82)73046-9","article-title":"Screening examination of the larynx and pharynx during upper gastrointestinal panendoscopy","volume":"28","author":"G Lehman","year":"1982","journal-title":"Gastrointest Endosc"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1136\/gut.2003.030130","article-title":"Controlled prospective evaluation of the diagnostic yield of a laryngopharyngeal screening examination during upper gastrointestinal endoscopy","volume":"53","author":"B Mullhaupt","year":"2004","journal-title":"Gut"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1007\/s00464-014-3796-z","article-title":"Visual evaluation of the larynx and hypopharynx during esophagogastroduodenoscopy: a safety and feasibility study","volume":"29","author":"S M Stevens","year":"2015","journal-title":"Surg Endosc"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1055\/s-2007-1005456","article-title":"Detection of subclinical disorders of the hypopharynx and larynx by gastrointestinal endoscopy","volume":"28","author":"S Watanabe","year":"1996","journal-title":"Endoscopy"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"1886","DOI":"10.1136\/gutjnl-2017-314109","article-title":"Quality standards in upper gastrointestinal endoscopy: a position statement of the British Society of Gastroenterology (BSG) and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS)","volume":"66","author":"S Beg","year":"2017","journal-title":"Gut"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1055\/s-0042-113128","article-title":"Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative","volume":"48","author":"R Bisschops","year":"2016","journal-title":"Endoscopy"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.gie.2014.07.057","article-title":"Quality indicators for EGD","volume":"81","author":"W G Park","year":"2015","journal-title":"Gastrointest Endosc"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1055\/s-2006-925127","article-title":"Accuracy of laryngeal examination during upper gastrointestinal endoscopy for premalignancy screening: prospective study in patients with and without reflux symptoms","volume":"38","author":"G Cammarota","year":"2006","journal-title":"Endoscopy"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.gie.2013.09.023","article-title":"Detection of pharyngeal cancer in the overall population undergoing upper GI endoscopy by using narrow-band imaging: a single-center experience, 2009-2012","volume":"79","author":"H Nakanishi","year":"2014","journal-title":"Gastrointest Endosc"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.gie.2013.02.021","article-title":"The pharynx: examination of an area too often ignored during upper endoscopy","volume":"78","author":"F Emura","year":"2013","journal-title":"Gastrointest Endosc"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/S1470-2045(15)00560-4","article-title":"Development and validation of a staging system for HPV-related oropharyngeal cancer by the International Collaboration on Oropharyngeal cancer Network for Staging (ICON-S): a multicentre cohort study","volume":"17","author":"B O\u02bcSullivan","year":"2016","journal-title":"Lancet Oncol"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/jnci\/djn025","article-title":"Distinct risk factor profiles for human papillomavirus type 16-positive and human papillomavirus type 16-negative head and neck cancers","volume":"100","author":"M L Gillison","year":"2008","journal-title":"J Natl Can Inst"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1007\/s10552-006-0036-4","article-title":"Intake of fruits and vegetables and risk of cancer of the upper aero-digestive tract: the prospective EPIC-study","volume":"17","author":"H Boeing","year":"2006","journal-title":"Cancer Cause Control"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1002\/1097-0142(195309)6:5<963::AID-CNCR2820060515>3.0.CO;2-Q","article-title":"Field cancerization in oral stratified squamous epithelium; clinical implications of multicentric origin","volume":"6","author":"D P Slaughter","year":"1953","journal-title":"Cancer"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1200\/JCO.2009.25.4680","article-title":"Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: a multicenter randomized controlled trial","volume":"28","author":"M Muto","year":"2010","journal-title":"J Clin Oncol"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"4999","DOI":"10.3748\/wjg.v17.i45.4999","article-title":"Diagnostic utility of narrow-band imaging endoscopy for pharyngeal superficial carcinoma","volume":"17","author":"N Yoshimura","year":"2011","journal-title":"World J Gastroenterol"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1111\/j.1442-2050.2009.01039.x","article-title":"Prospective evaluation of narrow-band imaging endoscopy for screening of esophageal squamous mucosal high-grade neoplasia in experienced and less experienced endoscopists","volume":"23","author":"R Ishihara","year":"2010","journal-title":"Dis Esoph"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/s11912-015-0498-1","article-title":"The role of narrow band imaging in head and neck cancers","volume":"18","author":"X G Ni","year":"2016","journal-title":"Curr Oncol Rep"}],"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1311-1014.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T23:34:27Z","timestamp":1611617667000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1311-1014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,25]]},"references-count":33,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2021,1,25]]},"published-print":{"date-parts":[[2021,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1311-1014","relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,25]]}}}