Abstract
INTRODUCTION: Oesophageal cancer is a major global health challenge and a leading cause of cancer-related deaths, particularly in SubSaharan Africa. Delayed presentation and limited diagnostic capacity contribute to its poor prognosis. Early recognition of endoscopic features predictive of malignancy may improve diagnostic yield and guide timely management. AIM: This study aimed to evaluate endoscopic features predictive of malignancy in patients with oesophageal lesions at a tertiary centre in North-western Nigeria. Methodology: A retrospective cross-sectional study was conducted at the Endoscopy Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto, from January 2018 to December 2022. Thirty-four patients with endoscopic findings of oesophageal lesions were included. Data on socio-demographics and endoscopic features (site, size, colour, bleeding, ulceration, and stricture) were extracted and analyzed using SPSS version 27. Chi-square test was applied, with p < 0.05 considered statistically significant. RESULTS: Of the 34 patients, 26 (76.0%) had histologically confirmed malignant lesions, while 8 (24.0%) were benign. Age and gender were not significantly associated with malignancy (p = 0.911 and 0.444, respectively). Similarly, lesions location and size did not show significant associations (p = 0.684 and 0.609). However, ulceration (p = 0.003), erythematous colour (p < 0.001), bleeding (p < 0.001), and stricture formation (p < 0.001) were significantly predictive of malignancy. CONCLUSION: The findings underscore the diagnostic value of certain endoscopic features, particularly ulceration, colour changes, bleeding, and strictures, in predicting malignancy. These observations align with international literature and emphasize the importance of careful endoscopic evaluation to enhance biopsy targeting and reduce missed diagnoses, especially in low-resource settings where advanced imaging modalities may not be readily available. KEYWORDS: Oesophageal cancer, Endoscopic indicators, Malignancy predictors, Oesophageal lesions, Cross-sectional study