Early detection of gastric cancer.

Hallissey, M. T.; Allum, William; Jewkes, A.; Ellis, David; Fielding, J. W. L.

doi:10.1136/bmj.301.6751.513

Cited by 181 publications

(74 citation statements)

References 21 publications

(3 reference statements)

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“…This is reflected in a 5-year survival as high as 90% for early gastric cancer [18]. Hallissey et al [19] have shown that the effective use of open access gastroscopy in Britain can achieve similar results, with the caveat that such outcomes depend largely on the awareness and effective use of this service by general practitioners. Nevertheless, despite the widespread introduction of open access gastroscopy in Britain, as many as one in three patients continue to present with advanced incurable cancers [4].…”

Section: Discussionmentioning

confidence: 83%

Prognostic significance of acute presentation with emergency complications of gastric cancer

et al. 2004

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Background. Although acute complications necessitating emergency hospital admission are well documented in patients with carcinoma of the colon, comparable data for patients with gastric carcinoma is thin. The aim of this study, therefore, was to examine the outcomes of patients presenting to hospital as acute admissions with emergency complications of previously undiagnosed gastric cancer. Methods. Three hundred consecutive patients with gastric adenocarcinoma were studied prospectively, and subdivided into two groups according to whether the patients were referred as acute emergencies (n ‫؍‬ 116) or as outpatients (n ‫؍‬ 184). Resuslts. The commonest emergency complications were: abdominal pain (57%), vomiting (41%), gastrointestinal bleeding (37%), dysphagia (26%), and a palpable mass (18%). Stages of disease were significantly more advanced in patients presenting acutely (I : II : III : IV ‫؍‬ 7 : 11 : 27 : 71) compared with patients referred via outpatients (20 : 23 : 50 : 91, 2 ‫؍‬ 3.955; DF, 1; P ‫؍‬ 0.047). R0 gastrectomy was significantly less likely after acute presentation (23 patients; 20%) compared with patients referred via outpatients (70 patients; 38%; 2 ‫؍‬ 11.037; DF, 1; P ‫؍‬ 0.001). Cumulative 5-year survival for patients referred acutely was 9%, compared with 22% after outpatient referral ( 2 ‫؍‬ 9.11; DF, 1; P ‫؍‬ 0.0025). Multivariate analysis revealed two factors to be significantly and independently associated with durations of survival: stage of disease (hazard ratio [HR], 1.742; 95% confidence interval [CI], 1.493-2.034; P ‫؍‬ 0.0001) and presentation with acute complications (HR, 1.561; 95% CI, 1.151-2.117; P ‫؍‬ 0.004). Conclusion. Emergency complications of gastric cancer are a significant and independent prognostic marker of poor outcome.

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Section: Discussionmentioning

confidence: 83%

Prognostic significance of acute presentation with emergency complications of gastric cancer

et al. 2004

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“…Seventeen identified factors that increased delay and six identified factors that decreased delay (Table 1). Delay in referral was primarily related to initial misdiagnosis of a common symptom or failure to make a diagnosis at the initial encounter with the patient (Bedikan et al, 1979;Nagao and Takahashi, 1979;Ojala et al, 1982;Hallissey et al, 1990;Arvanitakis et al, 1992;Rothwell et al, 1997). Moreover, referral was likely to be delayed if the patient was being treated for a benign condition, particularly with acid suppression (Mikulin and Hardcastle, 1987;Rothwell et al, 1997;Bramble et al, 2000).…”

Section: Factors Influencing Practitioner Delaymentioning

confidence: 99%

Systematic review of factors influencing patient and practitioner delay in diagnosis of upper gastrointestinal cancer

et al. 2006

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As knowledge on the causation of cancers advances and new treatments are developed, early recognition and accurate diagnosis becomes increasingly important. This review focused on identifying factors influencing patient and primary care practitioner delay for upper gastrointestinal cancer. A systematic methodology was applied, including extensive searches of the literature published from 1970 to 2003, systematic data extraction, quality assessment and narrative data synthesis. Included studies were those evaluating factors associated with the time interval between a patient first noticing a cancer symptom and presenting to primary care, between a patient first presenting to primary care and being referred to secondary care, or describing an intervention designed to reduce those intervals. Twenty-five studies were included in the review. Studies reporting delay intervals demonstrated that the patient phase of delay was greater than the practitioner phase, whilst patient-related research suggests that recognition of symptom seriousness is more important than recognition of the presence of the symptom. The main factors related to practitioner delay were misdiagnosis, application and interpretation of tests, and the confounding effect of existing disease. Greater understanding of patient factors is required, along with evaluation of interventions to ensure appropriate diagnosis, examination and investigation.

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“…Se ha descrito también, un incremento progresivo en la frecuencia del tipo difuso según Laurén llegando en algunos países a superar al tipo intestinal, esto último en estrecha relación con la localización tumoral, reportándose actualmente una mayor frecuencia de tumores ubicados en el tercio superior y cardial; condición descrita como esperable en países desarrollados mientras que tumores de tercio inferior son más frecuentes en países en vías de desarrollo 7,9,[10][11][12][13] . Del mismo modo, se ha descrito un aumento gradual en el diagnóstico de lesiones incipientes a través de los años con el consiguiente impacto en la supervivencia de estos pacientes, condición determinada principalmente por los programas de detección precoz instaurados en Japón, China y Corea; el mejoramiento tecnológico de equipos; y la capacitación continua de endoscopistas y patólogos [14][15][16][17] . Los cambios descritos estarían influenciados por múltiples factores entre los que se mencionan modificación de hábitos alimentarios con aumento en el consumo de vegetales y menor consumo de carnes y productos salados; uso masivo de la refrigeración de alimentos e implementación de tratamientos altamente efectivos en la erradicación del Helicobacter pylori 10,11,[18][19][20][21][22][23] .…”

Section: Introductionunclassified

Cáncer gástrico en una región de Chile: Comparación de variables clínicas y morfológicas en dos períodos (1986-1995 y 1996-2005)

Roa

et al. 2010

Rev Chil Cir

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Changes in morphological an clinical characteristics of gastric cancer from 1986 to 2005Background: In the last decade, changes in therapy and on the epidemiological and pathological behavior of gastric cancer have occurred in Chile. Aim: To compare the natural history of gastric cancer in two periods (1986-1995 and 1996-2005) in the ninth region of Chile. Material and Methods: Medical records of 563 gastrectomies for gastric cancer, performed between January 1986 and December 2005 and kept at a Pathology Unit of a public hospital, were reviewed. Clinical and morphological variables were analyzed (histological Lauren type, differentiation degree, location and macroscopic type, infiltration level, number of resected and involved lymph nodes). Results: A significant increase in the frequency of the diffuse type of gastric cancer was observed in the second period in study, with a concomitant decrease of the intestinal type. A reduction in tumor size and number of excised lymph nodes was also observed. Conclusions: In the second study period, morphological changes in gastric cancer, were observed.

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Early detection of gastric cancer.

Cited by 181 publications

References 21 publications

Prognostic significance of acute presentation with emergency complications of gastric cancer

Prognostic significance of acute presentation with emergency complications of gastric cancer

Systematic review of factors influencing patient and practitioner delay in diagnosis of upper gastrointestinal cancer

Cáncer gástrico en una región de Chile: Comparación de variables clínicas y morfológicas en dos períodos (1986-1995 y 1996-2005)

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