Endoscopy

Lower gastrointestinal endoscopy use in the 12 months before diagnosis was more common among patients with overweight and obesity than among normal-weight and underweight patients. The endoscopy difference was clearest for colon cancer, with higher use among patients with obesity than normal-weight patients. Endoscopy allows direct visualization of the stomach and duodenum. Higher endoscopy use among patients with overweight and obesity may help explain their lower emergency diagnosis risk. Higher symptom burden or heightened clinical suspicion may lead to more frequent diagnostic testing. The study examined lower gastrointestinal endoscopy use after the first relevant symptom and before colorectal cancer diagnosis. During endoscopy, tissue samples are collected for laboratory analysis. Endoscopy is required when severe conditions such as bleeding ulcers or gastric cancer are suspected.