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Hepatogastroenterology. 2003 May-Jun;50(51):873-6.

Management delays for early gastric cancer in a country without mass screening.

Author information

1
Department of Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Republic of Singapore. melvin_look@ttsh.com.sg

Abstract

BACKGROUND/AIMS:

To examine the symptoms of early gastric cancer and the time scale of management delays in a country without a mass screening program.

METHODOLOGY:

Retrospective review of 44 patients with early gastric cancer.

RESULTS:

Epigastric pain (63.3%) and gastrointestinal hemorrhage (27.3%) were the main symptoms found. Total delay was made up of patient delay (48.6%), doctor delay (25.5%) and treatment delay (25.9%). Median patient delay (from symptom onset to medical consult) was 30 days (inter-quartile range 2 to 365). Patient delay of more than 6 months was associated with patients aged 50 and younger (P = 0.04) and those presenting with pain (P = 0.05). Median doctor delay (consult to diagnosis) was 21 days (1 to 35) and median treatment delay (diagnosis to surgery) was 8 days (2 to 21). Doctor delay of more than 6 months was associated with a negative gastroscopy or barium meal in the previous 12 months (P = 0.03).

CONCLUSIONS:

The detection of early gastric cancer at the symptomatic-detectable stage is possible and this potential window for diagnosis can be more than 1 year for up to one third of cases. Efforts to reduce management delays should be aimed at public education and improving the quality and accessibility of endoscopic evaluation.

PMID:
12828108
[Indexed for MEDLINE]
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