In an attempt to assess the impact of upper gastrointestinal endoscopy on the outcome of patients with gastric cancer, we have studied 483 patients with gastric cancer from three centres with differing endoscopic practice. The introduction of an open access general practitioners endoscopy service led to a 10-fold increase in the number of endoscopies being performed per head of population, but there was no demonstrable effect on prognosis or on the duration of symptoms before diagnosis. There was no increase in the proportion of early gastric cancer diagnosed.
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