Early detection of gastric cancer

Abstract

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.