Blackshaw, G.; Edwards, P.; Barry, J.; Gent, C.; Allison, M.; Lewis, W.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA81
Academic Journal
Aims: To examine the time taken to diagnose gastric cancer identify the source of delay, and assess its clinical importance. Methods: Two hundred and fifty eight consecutive patients (median age 73 years, 55 months) with cancer of the stomach were studied prospectively. The main measures of outcome were the interval from the onset of symptoms to histological diagnosis, final pathological stage of the tumour, and whether potentially curative resection was possible. Indices of multiple deprivation related to electoral wards were obtained from the office of national statistics. Results: The median delay from first symptoms to diagnosis was 15 weeks (range 1-175). One hundred of the patients (39%) had incurable stage IV tumours at presentation, although no relation was found between diagnostic delay and tumour stage. Sixty seven patients (26%) had received blind acid suppression therapy from their general practitioners, which resulted in further and significant delays in diagnosis (median 20 compared with 12 weeks, p = 0.025). Diagnostic delay correlated significantly with indices of multiple deprivation for electoral divisions, as described by the Office for National Statistics (delay in consulting a doctor p = 0.044, total delay in diagnosis p = 0.025). Delays in diagnosis in patients from electoral wards with deprivation scores of 10 or less were significantly shorter than the delays in patients with scores of greater than 30 (7 compared with 20 weeks, p = 0.024). Conclusion: Long delays remain common in the diagnosis of cancer of the stomach. Measures in the community directed specifically at areas of high social deprivation, to educate the public and doctors alike, are required if patients with gastric cancer are to be diagnosed at an early and potentially curable stage.


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