HP serology as a screening method prior to upper gastro-intestinal endoscopy in young dyspeptic patients: a different point of view.

We performed a literature search as well as a review of our own results to evaluate HP serology as a screening method in young dyspeptic patients, prior to endoscopy. This strategy has been proposed by various teams in order to decrease the endoscopy workload. We analysed the results that could be obtained when not performing endoscopy in seronegative patients, in terms of avoided endoscopies and missed lesions. We found that too many lesions would remain undiagnosed, and thus untreated, regarding our reimbursement system, if the strategy was used without a strict selection of patients. The screening might be advisable among highly selected patients, but the percentage of avoided endoscopies would then decrease regarding the total number of endoscopies performed. Our conclusion is that HP serology as a screening method in young dyspeptic patients cannot be advised in Belgium for the time being.