Oesophagogastric (OG) cancers impact on quality of life and have poor survival outcomes. As OG cancers are uncommon and have some non-specific symptoms (e.g. weight loss), they can be challenging to detect early. This study aimed to quantify the extent of presenting symptoms among OG cancer patients at a hospital in the Loddon Mallee region of Victoria.
The Victorian Cancer Registry (VCR) was used to identify patients with a diagnosis of OG cancer (International Classification of Diseases and Related Health Problems-10 diagnosis codes C15 and C16) at a regional hospital over 1/7/2016-31/12/2017. An audit of presenting symptoms was conducted in electronic hospital systems. Proportions of OG cancer patients who presented with each individual symptom, and each two-way combination of dysphagia with another symptom, were calculated. Numbers <5 (<10%) were censored to meet VCR privacy requirements.
Fifty OG cancer patients were diagnosed at the regional hospital. The median age of subjects was 70 years and 78% were male. Metastatic disease was found in 36% of the cohort. Subjects presented with dysphagia (62%), weight loss (36%), constipation (18%), chest pain (14%), nausea/vomiting (14%), reflux (12%), epigastric pain (<10%), dyspepsia (<10%), and abdominal pain (<10%). Dysphagia was observed with all other symptoms: weight loss (28%), chest pain (10%), nausea/vomiting (10%), low haemoglobin (<10%), constipation (<10%), abdominal pain (<10%), dyspepsia (<10%), epigastric pain (<10%), and reflux (<10%).
Among OG cancer patients diagnosed at a regional Loddon Mallee hospital, the most common presenting symptoms were dysphagia and weight loss. This proportion was greater than in a UK study, likely reflecting the relatively high percentage of metastatic disease in our cohort (36% compared with 0.1%). General practitioners ought to be vigilant for OG cancer symptoms such as dysphagia and weight loss, particularly in combination.