title: Delay in diagnosis of gastric cancer: a prospective study evaluating doctors'- and patients' delay and its influence on five year survival.
abstract: Despite new diagnostic techniques, gastric cancer in its less aggressive stages is not diagnosed more frequently and the prognosis still remains poor. Thus, a possibility exists that there is still a delay in diagnosis. This study was therefore designed to investigate whether a delay in diagnosis of gastric cancer exists, to identify factors leading to diagnostic delay, and to settle whether the prognosis is dependent on a delay. Fifty consecutive patients with gastric carcinoma were interviewed and the diagnostic attempts prior to diagnosis were checked. It was found that thirteen patients (26%) had patients' delay (more than three months of symptoms before consulting a doctor) whereas twelve (24%) had doctors' delay (more than three months of investigations before correct diagnosis was made). Doctors' delay was more common in female (7/13) than in male patients (5/37) (p less than 0.05) and in linitis plastica (5/8) than in other types of gastric cancers (7/42), (p less than 0.05). Seven of the twelve patients with doctors' delay had been on regular check ups before diagnosis. A negative barium meal was the most common reason for doctors' delay. Survival was influenced only by tumour stage (r = -0.71, p less than 0.05). Our conclusion is that both patients' and doctors' delay are considerable in the diagnosis of gastric cancer; it is therefore suggested that improvement in five-year survival requires improved presymptomatic diagnostic methods and screening programmes.
authors.affiliation: Department of Surgery, Lund University, Sweden.
authors.forename: T L
authors.initials: TL
authors.lastname: Zilling
authors.forename: B S
authors.initials: BS
authors.lastname: Walther
authors.forename: B
authors.initials: B
authors.lastname: Ahren
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010819:Physician's Role; D012380:Role; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D013997:Time Factors