Diagnostic routes and symptom-to-treatment delays in gastric cancer: Findings from a cross-sectional study in southeastern China

Objectives

Prognosis of gastric cancer is strongly related to stage at diagnosis. Great attention should be given to reducing symptom-to-treatment delays in gastric cancer patients. We mainly aimed to describe diagnostic routes and symptom-to-treatment delays, as well as to explore the predictors of patient delays.

Study design

Retrospective cross-sectional study.

Methods

Between 1^st November 2021 and 31^st October 2022, all eligible consecutive patients with a first diagnosis of gastric cancer were recruited and interviewed at two Grade-A tertiary hospitals in southern China.

Results

A total of 533 gastric cancer patients were analyzed. The major diagnostic route was “visit the doctor with symptoms” (82.7 %). The median value was 21.5 days for patient interval, 5.0 days for diagnosis interval, and 10.0 days for treatment interval. About a quarter of patients had a patient delay (24.1 %), diagnosis delay (22.1 %), or treatment delay (28.9 %). Highest household monthly income (OR = 2.12, 95 % CI: 1.13–3.97), high/middle level of life stress (OR = 1.87, 95 % CI: 1.15–3.06), having symptoms of epigastric pain (OR = 2.06, 95 % CI: 1.27–3.35), first presentation to township hospital/county hospitals (OR = 9.49, 95 % CI: 3.29–27.42) or Grade-A tertiary hospital (OR = 13.41, 95 % CI: 4.40–40.84) were positively associated with patient delay. In contrast, ever had gastric cancer screening in the past 5 years (OR = 0.44, 95 % CI: 0.21–0.94), having symptoms of hematemesis/melena (OR = 0.23, 95 % CI: 0.09–0.61) were negatively associated with patient delay.

Conclusions

The majority of gastric cancer patients were diagnosed by visiting the doctor with symptoms. Symptom-to-treatment delays were common, highlighting the need to improve symptom appraisal, help-seeking behavior, and diagnostic pathways.