In message <VA.0000012d.08112bb8@burton>, Chris Burton
<[log in to unmask]> writes
>
>> Only if the likelihood of more serious pathology justifies it (eg first
>> presentation of suspicious symptoms in a patient over 45)
>>
>
>Local GI surgeons saying FIRST presentation of ANY symptom in >45 on the
>grounds that sinister symptoms usually mean stage 3-4 cancer in which
>case treatment is at best palliative. Apparently recent series from Leeds
>and Birmingham in enthusiastic open access units is increasing proportion
>at stage 1-2 (potentially curable apparently)to 30+ %. Will find out more
>if you're interested.
>
Yes I'd be very interested. What I meant by suspicious was, of course,
*any* first symptom in over 45s which would be suggestive of peptic
ulceration in younger patients (I suppose we should call it H pylori
associated upper GI symptoms now!"), or symptoms in such patients even
if they have a vague history of an ulcer 20 years before but nothing in
between (although I'd love to know if a history of "ulcer" 20 years ago
has a negative or positive likelihood ratio for gastric Ca when there is
a new presentation)
Toby
--
Toby Lipman 7, Collingwood Terrace, Jesmond, Newcastle upon Tyne. Tel
0191-2811060 (home), 0191-2437000 (surgery)
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