Diagnostics of stomach cancer in Russia: first results of the multicenter study “RADIUS” (Early diagnosis of stomach cancer in dyspepsia)
The aim of the study was to evaluate the timeliness and effectiveness of the diagnosis of precancerous diseases and early forms of gastric cancer in primary health care. Materials and methods. A multicenter retrospective descriptive study was conducted with an analysis of the medical records of 426 patients who were diagnosed with malignant neoplasm of the stomach at the time of going to outpatient facilities. We used data from 125 outpatient facilities in 7 centers for the period from 2009 to 2019. Results. The average age of patients with a first established diagnosis of malignant neoplasia was 61,7 (95% CI 58.6 ÷ 64.8) years. The prevailing form of malignant neoplastic disease was the option “Adenocarcinoma, intestinal cancer” - 77,7%, diffuse type cancer - 12,7%, other histological types - 9,6%. The diagnosis of malignant neoplastic disease at the III and IV stages of the disease was first established in 67,4% of patients. The number of years lived by patients with a diagnosis of gastric gastric cancer was 2,0 years. Over a 10-year follow-up, 75% of patients died. Risk factors for gastric cancer were identified in 41% of respondents. Signs of dyspepsia syndrome were observed in 31,5% of patients, and they appeared on average 4,6 (95% CI 4,4 ÷ 4,8) years before the diagnosis of gastric malignancy. Among people with gastric cancer, dyspepsia symptoms occur every day in every third patient. The features of the manifestations of dyspepsia in the observed patients were: daily manifestations of symptoms (33,3%), symptoms at night - 9,4%, an increase in the intensity of dyspepsia (21,3%), the lack of a clinical response to the therapy (proton pump inhibitors, prokinetics, eradication of Helicobacter pylori infection) in 58% of cases. Anxiety symptoms were recorded 2,4 years before a diagnosis of stomach cancer.