Early detection of gastric cancer.

Objective-To see whether investigation of dys- peptic patients aged over 40 after their first consulta- tion with the general practitioner would increase the proportions with early and operable gastric cancers.Design-Prospective study of gastric cancer in dyspeptic patients aged over 40 from a defined population.Setting-10 General practices (six in central Birmingham, four in Sandwell); the Queen Elizabeth Hospital, Birmingham; and Sandwell District General Hospital.Patients-2659 Patients aged 40 or over referred with dyspepsia.Main outcome measure-Increase in early and operable gastric cancers detected in middle aged patients with dyspepsia.Results-Disease was identified in 1992 patients (75%).Fifty seven were found to have gastric cancer, 36 being treated by potentially curative resection, including 15 with early cancer.Conclusions-The investigation of dyspeptic patients over 40 at first attendance can increase the proportion of early gastric cancers detected to 26% and the proportion of operable cases to 63%.Such a policy has the potential to reduce mortality from gastric cancer in the population.