Best practice dictates that a patient aged over 50 with long-standing problems of gastric reflux should have an endoscopy - but a recent study has concluded that it's yet another routine screening programme that has no benefit to the patient.
Frequent and severe reflux - where stomach contents back up into the oesophagus - could be an early sign of cancer of the oesophagus. Patients are therefore screened just in case.
But GERD (gastroesophageal reflux disease) is one of the most common problems seen by doctors. It's been estimated that half of all Americans suffer reflux once a month, while 20 per cent suffer it once a week, which translates into a vast screening initiative.
Even if the resources were in place to cope, endoscopic screening can produce unreliable findings while putting even more stress on an already overstretched health system. Perhaps the best argument against routine screening is the simple fact that the link between reflux and cancer is very slight, say researchers from the University of North Carolina (JAMA, 2002; 287: 1972-81).