The Cardiovascular
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Edinburgh Gastric Ulcer Score (EGUS)

Estimates malignancy risk in an endoscopically identified gastric ulcer.

Edinburgh Gastric Ulcer Score (EGUS)
Age
Ulcer size
Ulcer location
Result0 points

Lower-risk ulcer for malignancy based on age, size, and location.

EGUS
0

When to use

  • Estimating pre-test probability of malignancy in a newly diagnosed gastric ulcer to help plan follow-up endoscopy and biopsy strategy.

Formula

Points: age <68=0, 68-79=1, >=80=2; size <1.25cm=0, 1.25-2.99cm=2, >=3.00cm=3; location antral=0, non-antral=1. Range 0-6; score >=3 flags higher malignancy risk.

Pearls and pitfalls

  • Developed and validated in a UK (NHS Lothian) cohort of gastric ulcer patients.
  • A low score combined with benign endoscopic appearance and adequate benign biopsies carries a high negative predictive value for malignancy.

References

  1. Brindle WM, Grant RK, Smith M, et al; EGAR (Edinburgh GI Audit and Research) Collaborative. Risk stratifying gastric ulcers: development and validation of a scoring system. Frontline Gastroenterol. 2022;13(2):111-118.