Delay in Diagnosis of Upper Gastrointestinal Cancer: whose fault is it?

BACKGROUND: Stomach and esophageal cancers are both deadly and difficult to diagnose early. Stomach cancer is the second most common cancer in Asia. Both these are one of the most common causes of cancer related death in the world. AIM: To determine the mean time delay from appearance of the symptoms to the endoscope procedure [OGDS] and rationalized the reason for this delay in diagnosis. METHOD: This is a cross sectional study of stomach and esophageal cancer data from Jan 2004- July 2008. All patients' records of histologically confirmed stomach or esophageal cancers during the study period were reviewed. RESULT: Total of 112 consecutive patients with stomach and esophageal cancer were analysed. 86 cases of stomach and 26 cases of esophageal cancer were reviewed. The average age for stomach and esophageal cancers are 60.8 years and 58.4 years respectively. The mean duration from the first appearance of cancer symptoms to endoscope procedure was 32.4 weeks for stomach cancer patient and 16.7 weeks for esophageal cancer patients. The reasons for the delays are due to 1) self-medication, 2) Empirical treatment for dyspepsia using antacid and H2 antagonist, 3) Delay in endoscope procedure for high risk patients. CONCLUSION: Reducing the delay in endoscope procedure may lead to early detection of cancer and thereby may improve the prognosis of these patients.