Publication Name	World Journal of Gastrointestinal Oncology
Manuscript ID	123432
DOI	10.4251/wjgo.123432
Country	United States

Category	Gastroenterology & Hepatology
Manuscript Type	Retrospective Cohort Study
Article Title	Foregut malignancy after discordant fecal immunochemical test: A cohort study at a United States safety-net hospital
Manuscript Source	Unsolicited Manuscript
All Author List	Andrew John Cruz, Sandeep Gurram, Isabel Obias, Allen Luo, Gevork Salmastyan, Aravind Rajagopalan, Stefanie Bui, Roxanna Sharifi, Nikhilesh Kumar, Chester Hui, Erick Cruz Grave, Eric Yang, Amarachi Erondu and Theodor Griggs
Funding Agency and Grant Number
Corresponding Author	Andrew John Cruz, MD, Department of Medicine, University of Southern California/Los Angeles General Medical Center, 2020 Zonal Avenue, Los Angeles, CA 90033, United States. andrewjohn.cruz@med.usc.edu
Key Words	Fecal immunochemical test; Esophagogastroduodenoscopy; Foregut malignancy; Gastric cancer; Safety-net hospital; Colonoscopy concordance
Core Tip	At a United States safety-net hospital, all 11 foregut malignancies in fecal immunochemical test-positive patients occurred in those whose colonoscopy did not explain the positive result (6.4% vs 0%), including patients without symptoms or anemia. This association persisted after multivariable adjustment (adjusted odds ratio = 26.14) and across multiple sensitivity analyses. Foregut symptoms were equally prevalent in both groups, and all patients underwent esophagogastroduodenoscopy for standard clinical indications rather than discordant fecal immunochemical test status alone. None of the malignancy patients were smokers or heavy drinkers. These hypothesis-generating findings warrant confirmation in multicenter prospective studies.
Citation	Cruz AJ, Gurram S, Obias I, Luo A, Salmastyan G, Rajagopalan A, Bui S, Sharifi R, Kumar N, Hui C, Cruz Grave E, Yang E, Erondu A, Griggs T. Foregut malignancy after discordant fecal immunochemical test: A cohort study at a United States safety-net hospital. World J Gastrointest Oncol 2026; In press DOI: https://doi.org/10.4251/wjgo.123432
PDF	123432-in-press.pdf

Received	2026-05-19 07:28
Peer-Review Started	2026-05-19 07:30
First Decision by Editorial Office Director	2026-06-12 08:57
Return for Revision	2026-06-13 22:58
Revised	2026-07-02 23:06
Publication Fee Transferred	2026-07-15 04:34
Second Decision by Editor	2026-07-23 07:39
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-07-28 12:30
Articles in Press	2026-07-28 12:30
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5204 (online)
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