[Delay in diagnosis and treatment of gastric cancer from the begining of symptoms to surgery]

ABSTRACT

In developed countries diagnosis of gastric cancer is performed in early stages through screening and the 5 year survival rate has risen to 86%. Although the patients in developing countries have digestive symptoms for quite a while, they do not undergo early endoscopy. The patients refer to the physicians in developed stages. This research was conducted to determine the median time of delay from the beginning of symptoms to surgery. In this research 63 patients suffering from gastric cancer were investigated during 2004-2005. Research questionnaire was completed from patient's admission to endoscopy until surgery through interview with the patients. Mann- Whitney statistical test and SPSS software were used for data analysis. Out of 63 patients 48 [76.2%] were male and 43 [68.3%] rural esidents. The most common cancer area was cardia [31 patients] and the most common symptom was abdominal pain [28 patients]. The results showed of median total delay from the beginning of symptoms until surgery was 96 days, which the patient delays 8 days, from the first referring to endoscopy [General practitioner delay] 57 days, from endoscopy to pathology affirmation 12 days, and from pathology affirmation to surgery performance 7 days. Factors like place of residence, education, income and gender had no significant effect on the time of delay. Delay from referring to endoscopy performance and from performance of endoscopy to pathologic confirmation was higher than expected. Screening plan for timely referring of patients and performance of endoscopy seems essential. To reduce the time of delay cooperation of different units like medical education, hospital units, pathology and supply of necessary hospital equipment is highly recommended