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Early detection of gastric cancer
M T Hallissey1, W H Allum, A J Jewkes
1Department of Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham.
Objective:
To see whether investigation of dyspeptic patients aged over 40 after their first consultation with the general practitioner would increase the proportions with early and operable gastric cancers.
Design:
Prospective study of gastric cancer in dyspeptic patients aged over 40 from a defined population.
Setting:
10 General practices (six in central Birmingham, four in Sandwell); the Queen Elizabeth Hospital, Birmingham; and Sandwell District General Hospital.
Patients:
2659 Patients aged 40 or over referred with dyspepsia.
Main Outcome Measure:
Increase in early and operable gastric cancers detected in middle aged patients with dyspepsia.
Results:
Disease was identified in 1992 patients (75%). Fifty seven were found to have gastric cancer, 36 being treated by potentially curative resection, including 15 with early cancer.
Conclusions:
The investigation of dyspeptic patients over 40 at first attendance can increase the proportion of early gastric cancers detected to 26% and the proportion of operable cases to 63%. Such a policy has the potential to reduce mortality from gastric cancer in the population.