Adopting a New Standard for Upper Gastrointestinal Series; Challenges to Overcome

At our institution, we perform upper gastrointestinal (GI) series on 10-15 patients on a daily basis. Upper GI series remains the core of stomach cancer screening. The new standard for GI x-ray imaging was formally introduced at our institution in April 2018. For the first two years, there were no cases of stomach cancer identified by upper GI series. In the third year, there were two cases of stomach cancer that were identified after ingesting barium. The second case that was identified in June was early-stage cancer. We identified several areas of improvement through these two cases. First, the primary physician in charge of explaining the results of the examination was uninformed because technicians were unaware of the presence of lesions and did not order additional imaging. Second, we failed to strongly encourage patients to undergo follow-up tests despite their H. pylori -positive status from the previous year. It is important to maintain and improve the imaging skills of radiologists, and to ensure that our physicians are skilled at interpreting upper GI series.