Gastric Cancer Screening: Intention to Adhere and Patients' Perspective

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Helicobacter Pub Date : 2024-09-09 DOI:10.1111/hel.13135

João Carlos Silva, Mário Dinis-Ribeiro, Fernando Tavares, Diogo Libânio

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Abstract

Background and Aims

Gastric cancer (GC) is the third cause of cancer mortality worldwide. A screening strategy that combines an upper gastrointestinal endoscopy (UGIE) with a screening colonoscopy may be cost-effective in intermediate-risk regions. This study aimed to evaluate the intention to adhere to combined endoscopic screening and assess knowledge of GC symptoms, risk factors, and barriers to screening.

Methods

Cross-sectional study enrolling individuals eligible for CRC screening in northern Portugal, where a populational fecal occult blood test (FOBT) program is implemented. The validated PERCEPT-PREVENT tool was applied across three groups: (a) not yet invited to CRC screening, (b) FOBT-positive referred to colonoscopy, and (c) primary colonoscopy screening.

Results

A high acceptance rate was observed for combined endoscopic screening (94%; n = 264) [not yet invited to CRC screening 98% (n = 90) vs. FOBT-positive referred to colonoscopy 90% (n = 103) vs. primary colonoscopy 97% (n = 71); p = 0.017], with the vast majority reporting intention to adhere in the setting of full reimbursement (97%; n = 255). Most respondents were unaware of any possible GC symptom (76%; n = 213), risk factor (73%; n = 205), and UGIE-related complication (85%; n = 237). Regular follow-up with the primary care physician (Odds Ratio (OR) 27.59, 95% confidence interval (CI) 2.99–254.57), lower perceived negative health consequences of UGIE (OR 1.40, 95% CI 1.13–1.74), and lower perceived financial burden (OR 2.46, 95% CI 1.04–5.85) were the only factors independently associated with a higher intention to undergo combined screening.

Conclusions

Willingness to undergo combined endoscopic screening was notably high and positively impacted by lower perceived barriers. Additional efforts should be undertaken to improve levels of digestive health literacy.

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胃癌筛查：坚持筛查的意愿和患者的观点

背景和目的胃癌（GC）是全球第三大癌症死因。在中危地区，将上消化道内镜检查（UGIE）与结肠镜检查相结合的筛查策略可能具有成本效益。本研究旨在评估坚持进行联合内镜筛查的意向，并评估对消化道疾病症状、风险因素和筛查障碍的了解程度。方法在葡萄牙北部地区进行横断面研究，招募符合 CRC 筛查条件的人群，该地区正在实施一项人群粪便潜血试验 (FOBT) 计划。经过验证的 PERCEPT-PREVENT 工具适用于三类人群：(a) 尚未被邀请进行 CRC 筛查的人群；(b) FOBT 阳性转诊至结肠镜检查的人群；(c) 结肠镜初筛人群。结果联合内镜筛查的接受率很高（94%；n = 264）[尚未受邀进行 CRC 筛查的接受率为 98%（n = 90），而 FOBT 阳性转诊结肠镜检查的接受率为 90%（n = 103），初诊结肠镜检查的接受率为 97%（n = 71）；p = 0.017]，绝大多数受访者表示有意在全额报销的情况下坚持筛查（97%；n = 255）。大多数受访者不知道任何可能的 GC 症状（76%；n = 213）、风险因素（73%；n = 205）和 UGIE 相关并发症（85%；n = 237）。定期接受初级保健医生随访（比值比 (OR) 27.59，95% 置信区间 (CI)2.99-254.57）、较低的 UGIE 负面健康后果感知（OR 1.40，95% CI 1.13-1.74）和较低的经济负担感知（OR 2.46，95% CI 1.04-5.85）是唯一与较高的联合筛查意愿独立相关的因素。结论接受联合内镜筛查的意愿明显较高，并受到较低感知障碍的积极影响。应进一步努力提高消化系统健康知识水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.