GASTRIC CANCER IN YOUNG PATIENTS WITH NO ALARM SYMPTOMS: FOCUS ON DELAY IN DIAGNOSIS

Abstract

INTRODUCTION: There has been a tendency in recent years to delay endoscopy in dyspeptic patients younger than 45yrs with no so-called "alarm symptoms." This study was conducted to test whether this policy might lead to an increased rate of delayed diagnosis of gastric cancer. METHOD:Aretrospective study was carried out on gastric cancer patients younger than 45 years of age identied from databases in our hospital from October 2020 to September 2021. Characteristics analyzed included duration and features of dyspeptic symptoms, presence of alarm symptoms, time interval from the onset of symptoms to diagnosis and pathological characteristics. RESULTS: In the study group we found 30 patients had gastric cancer ( 17 females, 13 males). 06 patients (20%) presented with uncomplicated dyspepsia and 24 patients with (80%) alarm symptoms (persistent vomiting, anemia, weight loss, dysphagia). None had positive family history. In those with uncomplicated dyspepsia epigastric pain was the most common complaint (64.1%) followed by vomiting (30.4%). Weight loss was the most common alarm symptom (53.3%), followed by anorexia (46.6%). Of the 6 patients without alarm features 3 were having adenocarcinoma, 2 lymphoma, 1 signet ring cell carcinoma. The mean delay from rst symptoms to nal diagnosis was 16.8 weeks in patients with alarm symptoms and 29.3 weeks in patients without alarm symptoms CONCLUSION: Signicant proportion of young (<= 45yrs) gastric cancer patients present without alarm symptoms. We need to review the existing standard age criteria (>45 yrs) for endoscopy in dyspepsia without alarm features particularly in high gastric cancer prevalence areas.