An investigation was performed about clinical histories before hospitalization in 1142 cases of gastric cancer during 16 years from 1969 to 1984.
The average term from onset of the disease to hospitalization was 4.53 months which tends to decrease becoming 3.49 months in the latest 5 years. The patients had visited 0.72 other doctor in average before coming to our hospital, 0.35 in early cancer cases and 0.83 in advanced cases. The sources of patients of our surgery were as follows ; 60.5% were introduced from medical department of our hospital, 20.2% were introduced from other clinics or hospitals, 10.6% visited our surgical department directly, and 8.7% came to us after visiting one or some other doctors. The rate of early cancer cases were high and unresectable cases were low relatively in cases from our medical department and direct visitors to our surgical department.
The causative factors of delay of hospitalization more than one month were considered from both sides of patient and doctor. The results were ; no delay 55.3%, delay due to patient's fault 28.2%, delay due to doctor's fault 19.9%. The delay of hospitalization due to either side's fault was one factor of decreasing early cancers and increasing advanced cases. Among those with no delay, however, 22.6% were unresectable cases. Gastric cancers are too malignant to be cured by visiting hospitals with complaints. Gastric mass survey among symptomeless people is the only reasonable way to come out of this difficult situation.