C16
Do patients with oesophago-gastric cancer have a longer referral time and worse outcome if aged under 55? A prospective multicentre study
Nick Davies, Diana Bailey, Sam Mehta
South West Public Health Observatory, Salisbury, UK
Background
To assess the symptoms, duration of symptoms and stage at presentation, referral times and survival at one year in patients diagnosed with oesophago-gastric cancer under the age of 55 with a matched cohort over 55.
Method
All patients with oesophago-gastric cancer under the age of 55 diagnosed between 1st September 2005 and 31st August 2006 were included and every subsequent patient aged 55 and over. 26 hospitals were invited to participate. Data was collected to a proforma.
Results
17 hospitals participated and102 patients under the age of 55 included. The symptoms and the duration of symptoms (median 8 weeks) were similar between the groups. There were fewer fast track referrals from GPs in the under 55’s (29.4% vs. 40.2%) and time from GP referral to 1st hospital visit was significantly longer (median 14 days vs. 10 days). Stage at presentation was similar between groups. One year survival analysis showed under 55’s had a longer median survival (348 vs. 245 days p=0.03 log rank).
Conclusion
Although the referral time for under 55’s was longer, this had no effect on stage at presentation. Patients under 55 diagnosed with oesophago-gastric cancer appear to have a better prognosis than those over 55. Current GP referral guidelines focus on patients over 55, which is correct as under 55’s are being referred appropriately. Further work needs to identify symptoms associated with earlier stage disease, such as degrees of dyspepsia, to reduce the number of patients presenting with advanced disease in both age groups.
