Gastric Cancer Screening: Intention to Adhere and Patients' Perspective

• Published in: Helicobacter (Cambridge, Mass.) Vol. 29; no. 5; pp. e13135 - n/a
• Main Authors: Silva, João Carlos, Dinis‐Ribeiro, Mário, Tavares, Fernando, Libânio, Diogo
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-09-2024
• Subjects: Aged; Cancer; Cancer screening; Colon; Colonoscopy; Colonoscopy - psychology; Cross-Sectional Studies; early cancer detection; Early Detection of Cancer - methods; Endoscopy; Female; Gastric cancer; gastric cancer screening; gastrointestinal endoscopy; Humans; Intention; Male; Mass Screening - methods; Medical screening; Middle Aged; Occult Blood; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Patient Compliance - statistics & numerical data; Portugal; preventive medicine; Primary care; Risk factors; risk perception; Stomach Neoplasms - diagnosis; Portugal; gastric cancer screening; cancer screening; early cancer detection; gastrointestinal endoscopy; preventive medicine; risk perception
• ISSN: 1083-4389; 1523-5378; 1523-5378
• DOI: 10.1111/hel.13135

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.