{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:48:50Z","timestamp":1784958530455,"version":"3.55.0"},"reference-count":50,"publisher":"Royal College of General Practitioners","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJGP Open"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Late stage diagnosis of oesophageal and gastric cancer is common, which limits treatment options and contributes to poor survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To explore patients' understanding, experience and presentation of symptoms before a diagnosis of oesophageal or gastric cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design &amp; setting<\/jats:title><jats:p>Between May 2016 and October 2017, all patients newly diagnosed with oesophageal or gastric cancer were identified at weekly multidisciplinary team meetings at two large hospitals in England. A total of 321 patients were invited to participate in a survey and secondary care medical record review; 127 (40%) participants responded (102 patients had oesophageal cancer and 25 had gastric cancer). Of these, 26 participated in an additional face-to-face interview.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Survey and medical record data were analysed descriptively. Interviews were analysed using thematic analysis, informed by the Model of Pathways to Treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants experienced multiple symptoms before diagnosis. The most common symptom associated with oesophageal cancer was dysphagia (<jats:italic>n<\/jats:italic> = 66, 65%); for gastric cancer, fatigue or tiredness (<jats:italic>n<\/jats:italic> = 20, 80%) was the most common symptom. Understanding of heartburn, reflux and indigestion, and associated symptoms differed between participants and often contrasted with clinical perspectives. Bodily changes attributed to personal and\/or lifestyle factors were self-managed, with presentation to primary care prompted when symptoms persisted, worsened, or impacted daily life, or were notably severe or unusual. Participants rarely presented all symptoms at the initial consultation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The patient interval may be lengthened by misinterpretation of key terms, such as heartburn, or misattribution or non-recognition of important bodily changes. Clearly defined symptom awareness messages may encourage earlier help-seeking, while eliciting symptom experience and meanings in primary care consultations could prompt earlier referral and diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgpopen20x101001","type":"journal-article","created":{"date-parts":[[2020,1,8]],"date-time":"2020-01-08T05:45:16Z","timestamp":1578462316000},"page":"bjgpopen20X101001","source":"Crossref","is-referenced-by-count":34,"title":["Patient symptom experience prior to a diagnosis of oesophageal or gastric cancer: a multi-methods study"],"prefix":"10.3399","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6127-0157","authenticated-orcid":false,"given":"Elka","family":"Humphrys","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7191-6476","authenticated-orcid":false,"given":"Fiona 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