{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:11:28Z","timestamp":1787019088776,"version":"build-2736575974"},"reference-count":21,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>\n                    The role of esophagogastroduodenoscopy (EGD) in evaluating patients with a positive fecal occult blood testing (FOBT) or fecal immunochemical testing (FIT) and normal colonoscopy findings remains uncertain, with current recommendations based on limited and low-quality evidence. This retrospective cohort study (2012\u20132022) included consecutive patients with positive FOBT or fecal FIT and normal colonoscopy, alongside asymptomatic controls referred for routine EGD prior to bariatric surgery. Demographic, clinical, and endoscopic data were collected and analyzed. Predictors of upper gastrointestinal malignancy and clinically significant findings (CSFs) were examined. Among 858 patients with positive FOBT\/FIT and 2010 controls, significant differences in age and sex distribution were observed (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Hiatus hernia and reflux esophagitis were more common in controls (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.01). CSFs were more frequent in the FOBT-positive group (11.3% vs 8.3%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.01). On multivariate analysis, male sex, older age, and endoscopist experience (&gt;3\u2009years) were independent predictors of CSFs, while positive FOBT was not independently associated with their presence. The diagnostic yield of EGD in patients with positive FOBT\/FIT but normal colonoscopy is modest and comparable to that of asymptomatic controls. These findings suggest that universal EGD may not be routinely warranted in this setting, supporting instead a selective, risk-based approach. Prospective studies are warranted to confirm these findings and assess the cost-effectiveness of universal versus selective EGD in this population.\n                  <\/jats:p>","DOI":"10.1177\/10815589251393972","type":"journal-article","created":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T04:02:14Z","timestamp":1761364934000},"page":"564-570","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Utility of esophagogastroduodenoscopy in positive FOBT with negative colonoscopy: Yield of upper gastrointestinal malignancy and clinically significant findings"],"prefix":"10.1177","volume":"74","author":[{"given":"Randa","family":"Taher Natour","sequence":"first","affiliation":[{"name":"Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel"},{"name":"Department of Gastroenterology and Hepatology, Hillel Yaffe Medical Center, Hadera, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Mahamid","sequence":"additional","affiliation":[{"name":"Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel"},{"name":"Department of Surgery, Carmel Medical Center, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren","family":"Gal","sequence":"additional","affiliation":[{"name":"Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel"},{"name":"Department of Gastroenterology and Hepatology, Hillel Yaffe Medical Center, Hadera, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Mari","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nazareth EMMS Hospital, Israel"},{"name":"Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majd","family":"Khader","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Barzilai Medical Center, Ashkelon, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawi","family":"Hazzan","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel"},{"name":"Clalit Health Services, Northern Region, Afula, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadi","family":"Abu Baker","sequence":"additional","affiliation":[{"name":"Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel"},{"name":"Department of Gastroenterology and Hepatology, Hillel Yaffe Medical Center, Hadera, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2022.02.001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000495"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.05.013"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.20452\/pamw.16253"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.giec.2023.09.006"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0281557"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v26.i1.70"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38153.491887.7C"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.08.053"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2024.09.045"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.01.037"},{"issue":"2","key":"e_1_3_2_13_2","first-page":"113","article-title":"Gastroscopy following a positive fecal occult blood test and negative colonoscopy: systematic review and guideline","volume":"24","author":"Allard J","year":"2010","unstructured":"Allard J, Cosby R, Del Giudice ME, et al. Gastroscopy following a positive fecal occult blood test and negative colonoscopy: systematic review and guideline. Can J Gastroenterol 2010; 24(2): 113\u2013120.","journal-title":"Can J Gastroenterol"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1155\/2007\/713047"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-014-3445-3"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-016-2666-7"},{"issue":"5","key":"e_1_3_2_17_2","first-page":"2873","article-title":"A new-generation fecal immunochemical test (FIT) is superior to quaiac-based test in detecting colorectal neoplasia among colonoscopy referral patients","volume":"35","author":"Vasilyev S","year":"2015","unstructured":"Vasilyev S, Smirnova E, Popov D, et al. A new-generation fecal immunochemical test (FIT) is superior to quaiac-based test in detecting colorectal neoplasia among colonoscopy referral patients. Anticancer Res 2015; 35(5): 2873\u20132880.","journal-title":"Anticancer Res"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2024.04.028"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2023.02.013"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12664-011-0123-7"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9072172"},{"issue":"2","key":"e_1_3_2_22_2","first-page":"112","article-title":"The dynamic changing incidence of gastric cancer in Israel: time for a national surgical management committee?","volume":"24","author":"Bard V","year":"2022","unstructured":"Bard V, Brenner B, Kashtan H. The dynamic changing incidence of gastric cancer in Israel: time for a national surgical management committee? 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