The test and treat strategy for Helicobacter pylori infection has raised some concern since young gastric cancer patients may have no alarm symptoms.
In this study, researchers from Italy assessed the frequency of alarm symptoms in a series of young gastric cancer patients.
The team also evaluated the impact of absence of alarm symptoms on delay in diagnosis, and stage of gastric cancer at diagnosis and survival.
|59% of patients presented with uncomplicated dyspepsia.|
|Scandinavian Journal of Gastroenterology|
The team performed a retrospective study which included 92 gastric cancer patients less than 45 years of age. Patients were identified from 4 hospital databases between 1985 and 2001.
The researchers analyzed duration and features of dyspeptic symptoms, presence of alarm symptoms, time interval from the onset of symptoms to diagnosis, pTNM stage and survival.
They found that 59% of patients presented with uncomplicated dyspepsia and 41% with alarm symptoms.
In those with uncomplicated dyspepsia, epigastric pain was the most common complaint (64%), followed by vomiting (30%), heartburn, and nausea.
The team determined that weight loss was the most common alarm symptom (30%), followed by anorexia (11%), dysphagia or anemia (8%).
The mean delay from first symptoms to final diagnosis was 16.8 weeks in patients with alarm symptoms and 29.3 weeks in patients without alarm symptoms.
However, patients without alarm symptoms showed significantly less aggressive gastric cancer, compared to patients with alarm symptoms.
The team found that the 5-year survival rate in patients without alarm symptoms, and with a history of dyspepsia of more than 24 weeks, was higher than that in patients with early diagnosis.
Dr Maconi's team concluded, "A large proportion of young gastric cancer patients present without alarm symptoms".
"Despite the delay in diagnosis, these patients have a better outcome than those with alarm symptoms".
"Thus the delay in diagnosis of patients without alarm symptoms does not affect survival".