Gastric cancer is a type of neoplasia with a high global incidence and a low survival rate in
more advanced cases. With nonspecific symptoms, its diagnosis is often delayed, resulting in
an unfavorable prognosis. Although the "warning signs" for this type of cancer – anemia,
gastrointestinal bleeding, palpable abdominal mass, dysphagia, weight loss, persistent
vomiting, and age over 50 – may indicate malignancy, their diagnostic effectiveness is
questioned. In Brazil, especially in the Northern region where the incidence is notable,
requesting endoscopy based on such signs lacks confirmation. This study aims to evaluate the
accuracy of endoscopy based on "warning signs" in detecting gastric cancer, contributing to
more efficient screening and a better understanding of the disease. For this purpose, a case control study was conducted between August 2022 and June 2023 in the endoscopy department
of João de Barros Barreto University Hospital (HUJBB), where a questionnaire was
administered to the patients. The "cases" group consisted of 36 patients with a confirmed
diagnosis of gastric neoplasia, while the "control" group included 252 patients with dyspeptic
symptoms but without cancer. Data analysis revealed that the majority of patients were located
in Belém, with a predominance of female patients (58.7%). The average age was 53.1 years,
and the presence of warning signs averaged 1.8 per patient. The main warning signs related to
gastric cancer were age over 50, weight loss, absence of bleeding, and absence of anemia. The
association with these last two warning signs contradicts the literature, and non-ulcer dyspepsia
also showed a relationship with the absence of anemia, as did peptic ulcer disease, which was
associated with weight loss, indicating an overlap of warning signs both in gastric cancer and
in the absence of this diagnosis. These findings may indicate that the strategy of requesting
endoscopy based on warning signs is not appropriate. The warning signs traditionally listed in
the literature did not show adequate accuracy for detecting gastric cancer, highlighting the need
for more comprehensive research to support decision-making strategies regarding the request
for endoscopy and early diagnosis of neoplasia.
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