Do we adequately diagnose early gastric cancer in Turkey

Late diagnosis of patients with advanced gastric cancer is due to late admission of patients or overlooked early gastric cancers in early endoscopies. We retrospectively evaluated gastroscopic results in our clinic over 9 years and assessed outcomes of all patients diagnosed and treated for gastric cancers, including early gastric cancers. We retrospectively evaluated all gastroscopic reports in our hospital between January 2000 and January 2009, dividing these patients into two time periods: 2000-2004 and 2005-2009. For all patients with early gastric cancers, we assessed age, gender, macroscopic tumor type, location in the stomach, type of surgery, histopathological verification of the tumor, lymph node involvement and general patient condition. Of the 37,768 patients who underwent gastroscopy, 3.53% (536 patients) during 2000-2004 and 4.3% (973 patients) during 2005-2009 were diagnosed with gastric cancer. During these two time periods, 21 (3.91%) and 61 (6.26%), respectively, of the patients who underwent radical surgical intervention were diagnosed with histopathologically proven early gastric cancers. The rate of early gastric cancers among patients with gastric cancer was lower in Turkey than in western countries and Japan. As in other western countries, screening endoscopy is not feasible in Turkey. The use of chromoendoscopy and magnified endoscopy, particularly in patients with alarm symptoms and in risk groups, may increase the rate of early diagnosis.