Patient symptom experience prior to a diagnosis of oesophageal or gastric cancer: a multi-methods study

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Figure 1. Participant and clinical perspectives of heartburn, reflux, and indigestion.^35–37
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Figure 2. First symptom presented to the GP compared with symptom experience before diagnosis, stratified by cancer type.

Table 1. Participant, healthcare, and disease characteristics

	Survey participants(n = 127)^a	Interview participants(n = 26)^a
Age, years
Median (range)	71 (44–96)	69.5 (55–88)
<60	12 (9.4^b)	3 (11.5)
60–74	78 (61.4^b)	12 (46.2)
≥75	37 (29.1^b)	11 (42.3)
Sex
Male	102 (80.3)	18 (69.2)
Female	25 (19.7)	8 (30.8)
Cancer type
Oesophageal^c	102 (80.3)	15 (57.7)
Gastric^d	25 (19.7)	11 (42.3)
Ethnic group
White	124 (97.6)	26 (100.0)
Other	3 (2.4)	0 (0.0)
Region
East	77 (60.6)	13 (50.0)
North East	50 (39.4)	13 (50.0)
Comorbidities
Arthritis	38 (29.9)	13 (50.0)
Cancer — other than O/G	22 (17.3)	5 (19.2)
Heart disease	17 (13.4)	2 (7.7)
Lung disease	13 (10.2)	2 (7.7)
Anxiety or depression	13 (10.2)	2 (7.7)
Barrett’s or reflux disease	10 (7.9)	1 (3.8)
Any of the above	72 (56.7)	16 (61.5)
OTC medication
None	79 (62.2)	17 (65.4)
Antacid or similar	30 (23.6)	7 (26.9)
Other	8 (6.3)	1 (3.8)
Reported GP consultations
None^e	13 (10.2)	6 (23.1^b)
1	56 (44.1)	10 (38.5^b)
2	35 (27.6)	4 (15.4^b)
≥3	21 (16.5)	6 (23.1^b)
Referral route
Urgent^f	88 (69.3)	16 (61.5)
Routine	19 (15.0)	6 (23.1)
Other	9 (7.1)	2 (7.7)

Urgent referral based on GP consultations
None^e	8 (6.3)	2 (7.7^b)
1	41 (32.3)	8 (30.8^b)
2	24 (18.9)	2 (7.7^b)
≥3	15 (11.8)	4 (15.4^b)
Cancer stage pre-treatment
I/II	59 (46.5)	12 (46.2)
III/IV	64 (50.4)	14 (53.8)

^aValues are n (%) unless otherwise stated. Missing data not included ^bPercentages subject to rounding error. ^cTumours located in the upper or middle or lower oesophagus and gastro-oesophageal junction, including both adenocarcinomas and squamous cell carcinomas. ^dTumours located in the cardia, fundus, body, antrum, or pylorus. ^ePatient referred opportunistically, that is, having attended primary care for another reason. ^fUrgent referral is the 2-week wait suspected cancer pathway.
O/G = oesophageal or gastric. OTC = over the counter.