{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:38:56Z","timestamp":1787027936883,"version":"build-2736575974"},"reference-count":28,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T00:00:00Z","timestamp":1762041600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and aim: The necessity and diagnostic yield of routine gastroscopy in Fecal Immunochemical Test (FIT)-positive patients with normal colonoscopy findings remains controversial and poorly defined. Here, we aimed to investigate the prevalence and clinical significance of upper gastrointestinal lesions detected by gastroscopy in FIT-positive patients, stratified by normal and abnormal colonoscopy findings. Methods: This retrospective study included 38,392 adults (\u226518 years) who tested positive for FIT between 2016 and 2022 across eight medical centers in Israel. Of them, 1560 patients underwent routine bi-directional endoscopic evaluation and were included in the final analysis. Comprehensive procedural data were retrieved, including detailed colonoscopic and gastroscopic findings. Colonoscopy outcomes included the detection of neoplastic and precancerous lesions, with the rates of adenoma and polyp detection calculated. Gastroscopy findings, including gastritis, hiatal hernia, esophagitis, duodenitis, peptic ulcer disease, and malignancy, were analyzed and compared between patients with normal and abnormal colonoscopy results. Results: Among 38,392 FIT-positive adults, 1560 underwent bidirectional endoscopy; of these, 632 (40.5%) had normal and 928 (59.5%) had abnormal colonoscopy findings. Gastroscopy revealed upper GI findings in both groups, with gastritis detected in 55.5% (normal colonoscopy) vs. 48.7% (abnormal colonoscopy), hiatal hernia in 15% vs. 14.9%, esophagitis in 9.0% vs. 10.3%, and duodenitis in 6.6% vs. 7.3%. Gastric ulcers were rare, observed in 0.95% of patients with normal colonoscopy and 1.29% with abnormal colonoscopy. No cases of upper gastrointestinal malignancy were detected in either group. Conclusions: Routine gastroscopy in FIT-positive patients demonstrates limited diagnostic yield, with clinically significant upper gastrointestinal lesions being rare.<\/jats:p>","DOI":"10.3390\/diagnostics15212781","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:55:22Z","timestamp":1762178122000},"page":"2781","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Limited Diagnostic Yield of Routine Gastroscopy in FIT-Positive Patients"],"prefix":"10.3390","volume":"15","author":[{"given":"Majd","family":"Khader","sequence":"first","affiliation":[{"name":"Gastroenterology Institute, Assuta Medical Center, Beer-Sheva 8489507, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5428-7180","authenticated-orcid":false,"given":"Fadi","family":"Abu Baker","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Hillel Yaffe Medical Center, Hadera 38100, Israel"},{"name":"Faculty of Medicine, Technion, Haifa 3200003, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge-Shmuel","family":"Delgado","sequence":"additional","affiliation":[{"name":"Gastroenterology Institute, Assuta Medical Center, Beer-Sheva 8489507, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avraham","family":"Yitzhak","sequence":"additional","affiliation":[{"name":"Gastroenterology Institute, Assuta Medical Center, Beer-Sheva 8489507, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Revital","family":"Guterman","sequence":"additional","affiliation":[{"name":"Gastroenterology Institute, Assuta Medical Center, Beer-Sheva 8489507, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruhama","family":"Elhayany","sequence":"additional","affiliation":[{"name":"Gastroenterology Institute, Assuta Medical Center, Beer-Sheva 8489507, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Or","family":"Bakshi","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"},{"name":"Maccabi Health Services South District, Beer-Sheva 8448102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vered","family":"Klaitman","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"},{"name":"Maccabi Health Services South District, Beer-Sheva 8448102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tali","family":"Braun","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"},{"name":"Maccabi Health Services South District, Beer-Sheva 8448102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4844-3308","authenticated-orcid":false,"given":"Naim","family":"Abu-Freha","sequence":"additional","affiliation":[{"name":"Gastroenterology Institute, Assuta Medical Center, Beer-Sheva 8489507, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rimon","family":"Artoul","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel"},{"name":"Geriatrics Department, Barzilai Medical Center, Ashkelon 7830604, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.puhe.2024.12.011","article-title":"Global, regional, and national burden of early-onset colorectal cancer and projection to 2050: An analysis based on the Global Burden of Disease Study 2021","volume":"238","author":"Li","year":"2025","journal-title":"Public Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"101839","DOI":"10.1016\/j.bpg.2023.101839","article-title":"Colorectal cancer: A health and economic problem","volume":"66","author":"Klimeck","year":"2023","journal-title":"Best Pract. 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Dis."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/21\/2781\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T14:08:02Z","timestamp":1762178882000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/21\/2781"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,2]]},"references-count":28,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["diagnostics15212781"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15212781","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,2]]}}}