To investigate the time from symptom onset to visit doctor and diagnosis of gastric cancer in Jiading district of Shanghai.To understand the influencing factors and analyze the reasons for its gap with the international community.

The clinical data of 1 279 patients with gastric cancer diagnosed by pathology in the Ruijin Hospital North Affiliated to Shanghai Jiao Tong University School of Medicine from December 2012 to April 2020 were collected.The symptoms of patients first visit(according to common " gastric cancer alarm symptoms" : abdominal pain, abdominal distension, acid regurgitation, belching, nausea and vomiting, hematemesis and melena, weakness and poor appetite, etc.), visiting time and diagnosis time(endoscopic biopsy or surgical pathological diagnosis)were investigated.Multivariate Logistic regression model and other methods were used for statistical analysis of the factors influencing the visiting and diagnosis of patients.

The main symptoms of 1 279 patients were abdominal pain in 556(43.47%), bloating, acid regurgitation and belching in 389(30.42%), black stools, hematemesis and fatigue in 205(16.03%), food obstruction, nausea and vomiting in 87(6.80%), and elevated tumor indexes found by physical examination in 42(3.28%). The average medical visit time was(1.25±0.55)months, which was related to the patients′ symptoms, the distance and the way of payment of medical expenses.The average diagnosis time was(4.76±1.85)months, which was related to the time of the patients′ visit and whether the first visit was performed by gastroscopy.Logistic regression analysis showed that symptoms(OR=1.545, 95% CI: 1.341-1.781)and medical expenses payment method(OR=1.939, 95% CI: 1.021-3.681)were risk factors for timely diagnosis of gastric cancer.Medical treatment distance(OR=1.695, 95% CI: 1.509-1.989)and the choice of gastroscopy for first visit(OR=1.008, 95% CI: 1.049-1.124)were protective factors for timely diagnosis of gastric cancer.

The symptoms of gastric cancer patients in Jiading area of Shanghai are mainly abdominal pain, distension, regurgitation of acid, belching, hematemesis, black stools, and fatigue.The time of visit and diagnosis was longer than that in foreign countries, which was related to the patients′ awareness of gastric cancer and gastroscopy, medical treatment distance, medical expense payment route and other factors.