Characteristics and Demographics of Patients in NI 2018-2019 Oesophago-Gastric Cancer Audit

Background: In Northern Ireland (NI) on average during 2015-2019  there were 154 males and 63 females diagnosed with oesophageal cancer per year, and there were 127 males and 73 females diagnosed with gastric cancer each year (1,2).
National Cancer Audits are performed with the view to improving patient care and outcomes. The last oesophago-gastric (OG) cancer audit was conducted in NI for patients diagnosed in 2005
Aims:
To measure the patient characteristics of OG cancer patients diagnosed 2018-2019
To quantify the number of patients with symptoms at presentation
To measure the co-morbidities that patients have at presentation
Methods:
Clinical data on all 759 patients with unique primary OG cancer ICD 03 codes C15-C16 diagnosed in 2018 & 2019 in NI were evaluated by the NICR. Patients where categorised by histological subtype and location of tumour to the following categories:
Oesophageal squamous cell carcinoma
Adenocarcinoma of oesophagus and oesophago-gastric junction (OGJ) Siewert levels I-II.
Stomach Cancer and oesophago-gastric junction (OGJ) Siewert level III.
Analysis was completed using STATA v.15
Results: Figure 1 and Table 1 shows the highest proportion of cases (48%) of OG cancer cases in NI arise in the oesophagus and OGJ with a adenocarcinoma histology. For all OG cancer subtypes the majority of cases were male with variation between subtypes of 55%-80%. The median age of patients with OG cancer is 70years old, with the majority of patients being diagnosed at 60+ years of age. The patient mix is complex, Table 2 shows that 72% of patients are diagnosed with at least 1 significant co-morbidiity with hypertension being the most common health condition. Over 1 in 10 patients had a previous malignancy.
Figure 3 shows that the majority of patients are symptomatic. Dysphagia is the most common symptom in oesophageal cancer patients (37%) and anaemia is the most common symptom in stomach cancer patients (43%).
Figure 4 shows for all subtypes the majority of cases are diagnosed at an advanced stage 3-4
Conclusions:
OG cancer patients in NI during 2018-2019 are a complex mix of patients that in the majority of cases are presenting at an advanced age, an advanced stage of disease, symptomatic and with other significant co-morbidities. This needs to be accounted for when auditing OG cancer care.