title: Delays in diagnosis and therapy of gastric cancer and esophageal adenocarcinoma.
abstract: OBJECTIVE
  In the past, there were long delays in the diagnosis of patients with cancer of the stomach or esophagus. The objective of this study was to describe current delays in the diagnosis and treatment of gastric and esophageal adenocarcinoma and to compare the findings with those from an historical control population treated at the same institutions 10 years earlier.
  
  
  METHODS
  Patients with biopsy-proven gastric cancer or esophageal adenocarcinoma who were treated at two academic medical centers in Germany between April and October 2003 were consecutively screened for eligibility to take part in the study. Medical charts for each patient were reviewed. Additional data were obtained via structured interviews. Main outcome measures were the total delay, and the delays related to patients themselves, to doctors, and to the hospital. Data were compared with those from a historic control group assessed in 1993.
  
  
  RESULTS
  The median total delay for patients with gastric cancer (n = 104) was 3.5 months (range 0.3 - 29.6), and in patients with esophageal adenocarcinoma (n = 22) the total delay was significantly shorter (median 2.2 months, range 1.2 - 11.7; P < 0.05). Comparing these findings with those from an historic cohort of patients with gastric cancer (n = 100) revealed a significant decrease in the total delay (3.5 versus 8.0 months, P < 0.001).
  
  
  CONCLUSIONS
  The current findings indicate that delays in the diagnosis and treatment of gastric cancer have become significantly shorter within the last 10 years as our understanding of and ability to treat this form of cancer have improved.
authors.affiliation: Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Witzig
authors.forename: B
authors.initials: B
authors.lastname: Schönberger
authors.forename: U
authors.initials: U
authors.lastname: Fink
authors.forename: R
authors.initials: R
authors.lastname: Busch
authors.forename: H
authors.initials: H
authors.lastname: Gundel
authors.forename: A
authors.initials: A
authors.lastname: Sendler
authors.forename: C
authors.initials: C
authors.lastname: Peschel
authors.forename: J R
authors.initials: JR
authors.lastname: Siewert
authors.forename: F
authors.initials: F
authors.lastname: Lordick
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000458:organization & administration; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010819:Physician's Role; D012959:Socioeconomic Factors; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D013997:Time Factors