title: Feasibility, safety, acceptability, and yield of office-based, screening transnasal esophagoscopy (with video).
abstract: BACKGROUND
  Endoscopic screening for esophageal neoplasia can identify patients eligible for early intervention for precancerous lesions. Unsedated transnasal esophagoscopy may provide an efficient and accurate endoscopic assessment with fewer risks and less cost, compared with conventional upper endoscopy.
  
  
  OBJECTIVE
  To assess the feasibility, safety, acceptability, and yield of unsedated transnasal esophagoscopy in a primary care population.
  
  
  METHODS
  Multicenter, prospective, cross-sectional study.
  
  
  METHODS
  Two outpatient tertiary-care centers.
  
  
  METHODS
  This study involved a general medical clinic population aged between 40 and 85 years.
  
  
  METHODS
  Unsedated, office-based transnasal esophagoscopy.
  
  
  METHODS
  Procedure yield; completeness of examination; procedure length; adverse events and complications; choking, gagging, pain, or anxiety during the examination; and overall tolerability.
  
  
  RESULTS
  A total of 426 participants (mean [± standard deviation] age 55.8 ± 9.5 years; 43% male) enrolled in the study, and 422 (99%) completed the examination. Mean (± standard deviation) examination time was 3.7 ± 1.8 minutes. There were no serious adverse events, and 12 participants (2.8%) reported minor complications. Participants reported minimal choking, gagging, pain, or anxiety. The examination was well-tolerated by most participants. Overall, 38% of participants had an esophageal finding that changed management (34% erosive esophagitis, 4% Barrett's esophagus).
  
  
  CONCLUSIONS
  Nonrandomized study, tertiary-care centers only, self-selected population with a large proportion reporting esophageal symptoms.
  
  
  CONCLUSIONS
  Unsedated transnasal esophagoscopy is a feasible, safe, and well-tolerated method to screen for esophageal disease in a primary care population. Endoscopic findings are common in this patient population.
authors.affiliation: Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Anne F
authors.initials: AF
authors.lastname: Peery
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Hoppo
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Garman
authors.forename: Evan S
authors.initials: ES
authors.lastname: Dellon
authors.forename: Norma
authors.initials: N
authors.lastname: Daugherty
authors.forename: Susan
authors.initials: S
authors.lastname: Bream
authors.forename: Alejandro F
authors.initials: AF
authors.lastname: Sanz
authors.forename: Jon
authors.initials: J
authors.lastname: Davison
authors.forename: Melissa
authors.initials: M
authors.lastname: Spacek
authors.forename: Diane
authors.initials: D
authors.lastname: Connors
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Faulx
authors.forename: Amitabh
authors.initials: A
authors.lastname: Chak
authors.forename: James D
authors.initials: JD
authors.lastname: Luketich
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Shaheen
authors.forename: Blair A
authors.initials: BA
authors.lastname: Jobe
mesh_terms: D000368:Aged; D000402:Airway Obstruction / Q000209:etiology; D000553:Ambulatory Care / Q000379:methods; D001007:Anxiety / Q000209:etiology; D001471:Barrett Esophagus / Q000175:diagnosis; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000379:methods*; D004938:Esophageal Neoplasms / Q000175:diagnosis*; D004941:Esophagitis / Q000175:diagnosis; D004945:Esophagoscopy / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D005683:Gagging; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D013997:Time Factors