Prevalence of carcinoma stomach in a tertiary referral centre in Eastern India and its correlation with endoscopic findings.

Carcinoma stomach still remains a major killer cancer all over the world. Delay in early diagnosis or lack of awareness, infrastructure etc. is the major factor for late presentation in developing countries. This work was carried out to study the prevalence of carcinoma stomach in a tertiary referral centre in Eastern India and its corroboration with endoscopic findings. The aim is to create an awareness regarding early diagnosis of this monstrous killer. The study was conducted on 8706 symptomatic patients attending for upper GI endoscopy, of which 165 patients were found to have adenocarcinoma of stomach and 8 patients with other stomach neoplasms. The age, sex, religious status and economic background were analysed. The endoscopic findings, histological nature and grading, site of the lesions vis-à-vis clinical signs and symptoms were analysed and statistically reviewed. Of the total 165 cases of carcinoma stomach, highest number of cases (24.8%) were among 40-49 years of age, followed by 50-59 years (23.7%). The male sex (67.6%) and patients with low socio-economic background (75.7%) were the worst sufferer. On gross microscopic findings of endoscopy, ulcero-proliferative lesions were highest (80.8%) and antrum was the commonest (46.8%) site of neoplastic lesions. Histologically, adenocarcinoma (95.4%) was commonest. The significant symptoms of presentation were pain abdomen (84%), weight loss (89%), anorexia (86%), gastric outlet obstruction (40%) while signs were anaemia (100%), epigastric tenderness (60%), lump abdomen and gastric outlet obstruction (40%). We found a large number of neoplastic lesions in endoscopy series with the highest number in males at forty. This implies a gross economic fall out on the family. The interesting finding of antral growth differs from western series. Liberal use and availability of endoscopy may help in detecting the lesions early with better outcome.