Authors argue against routine gastroscopy for low-risk younger patients

The authors respond to a call to offer gastroscopy and biopsy to all patients with chronic upper gastrointestinal symptoms. They note that *Helicobacter pylori* can usually be detected with non-invasive tests and treated without endoscopy, and that gastric cancer has become less common and is rare in people younger than 55 years. They say international guidance supports test-and-treat for younger patients with dyspepsia and no alarm symptoms, reserving gastroscopy primarily for those at higher risk.

The article reports that more than 100,000 gastroscopies are performed annually in Norway, with a substantial proportion in people under 55. The authors argue that reducing low-yield procedures could release endoscopy capacity for services with documented benefit, but provide no estimate of the number of procedures that could be avoided or the resulting health or economic effects.

This is an opinion piece, not a comparative study or new guideline. Its central point is that recommendations to expand gastroscopy should quantify expected health gains, costs and opportunity costs. The claims about practice reflect cited international guidance; the article does not present new outcome data or establish the effects of changing endoscopy use.