近七成患者有症状才就医，胃癌早诊率低如何破局

《中国胃癌患者生存质量白皮书》近日发布，揭示了我国胃癌诊治中存在的突出问题。1近七成患者因出现症状才就医发现疾病，其中约四成患者存在延迟就医情况。1确诊时已处于III期和IV期的患者占比高达55.2%，反映出我国胃癌早期诊断能力严重不足。1相比之下，中国早期胃癌诊治率长期低于10%，远低于日本的70%和韩国的50%。1

提升胃癌早诊率需要多管齐下。专家指出，应通过精准识别高危人群、建立常态化内镜筛查机制、补齐医务人员诊疗认知短板等措施应对这一挑战。1与此同时，分子水平的检测覆盖率有待提高，CLDN18.2患者知晓率达63.5%，但实际检测率仅为36.9%，国内胃癌分子规范检测覆盖率不足，接受新辅助治疗的患者占比不到2%。1

综合干预对改善患者预后至关重要。研究表明，82.4%的胃癌患者存在轻度及以上营养不良，其中中重度营养不良占57.5%；87.4%患者患病后出现不同程度社交受限。1一项III期随机对照研究显示，接受早期营养与心理多学科支持的患者中位总生存期为14.8个月，相比常规治疗患者的11.9个月明显延长。1此外，64.7%的患者表示愿意接受新型胃癌靶向治疗。1

The China Gastric Cancer Patient Quality of Life White Paper reveals a troubling pattern in how gastric cancer is detected in China. 1 Nearly 70% of patients seek medical attention only after symptoms have emerged, and among those who do seek care due to symptoms, approximately 40% experience delayed diagnosis. 1 At the time of diagnosis, 55.2% of patients are already in stage III or IV disease. 1

The disparity in early detection rates between China and other developed nations underscores the severity of the problem. China's early gastric cancer diagnosis and treatment rate has remained persistently below 10%, starkly lagging behind Japan's approximately 70% and South Korea's approximately 50%. 1 Experts emphasize that improving this situation requires a multipronged strategy, including precisely identifying high-risk populations, establishing routine endoscopic screening mechanisms, and closing knowledge gaps among medical professionals regarding diagnosis and treatment protocols. 1

Beyond detection challenges, the research highlights additional barriers to optimal outcomes. While 64.7% of patients express willingness to receive novel targeted gastric cancer therapies, molecular testing coverage remains inadequate nationally. Only 36.9% of patients actually undergo CLDN18.2 testing despite 63.5% awareness of this marker. 1 Additionally, fewer than 2% of patients receive neoadjuvant therapy domestically. 1 Comprehensive patient support also remains insufficient: 82.4% of patients experience at least mild malnutrition, with 57.5% suffering moderate to severe nutritional deficiency, and 87.4% report varying degrees of social limitations following diagnosis. 1 A phase III randomized controlled trial demonstrates the potential of multidisciplinary intervention, showing that patients receiving early nutritional and psychological support achieved a median overall survival of 14.8 months compared to 11.9 months in those receiving standard treatment alone. 1