Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China.
Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
BMJ Open. 2023 Jul 20;13(7):e073925. doi: 10.1136/bmjopen-2023-073925.
This study aimed to identify the determinants of gastric cancer screening attendance among individuals aged 40 years in a region with high gastric cancer in China.
An anonymous, cross-sectional survey was conducted between October 2021 and March 2022.
A self-administered online survey was conducted in Fujian Province in Southeastern China.
People aged 40 years living in five selected cities in Fujian Province with no history of cancer.
Gastric cancer screening attendance was measured with the question 'Have you ever been screened for gastric cancer in the past'.
In total, 2547 complete responses were obtained. The mean age of respondents was 47.72±7.20 years, and 59.8% were men. A total of 42.6% of participants reported that they had undergone gastric cancer screening. The result of multivariable logistic regression analysis showed that participants with a first-degree relative affected with gastric cancer (OR=2.02, 95% CI: 1.58 to 2.59) and high perceived susceptibility of gastric cancer (OR=2.03, 95% CI: 1.58 to 2.59) were the strongest facilitators for screening attendance. Other factors positively associated with screening attendance were age 51-60 years (OR=1.69, 95% CI: 1.31 to 2.18), living in urban regions (OR=1.27, 95% CI: 1.05 to 1.55), friends/neighbours/colleagues with gastric cancer (OR=1.30, 95% CI: 1.07 to 1.58), history of chronic gastric disease (OR=1.90, 95% CI: 1.57 to 2.30), perceived high cost (OR=1.28, 95% CI: 1.01 to 1.61) and physician recommendation (OR=1.71, 95% CI: 1.36 to 2.16). On the other hand, factors negatively associated with screening attendance included perceived barriers, namely screening is only necessary when symptoms present (OR=0.71, 95% CI: 0.58 to 0.87) and perceived appointment for gastroscopy screening is difficult and time-consuming (OR=0.75, 95% CI: 0.60 to 0.94). No significant association was found between knowledge level and participation in screening.
This study highlights important individual-level factors and barriers to gastric cancer screening. Strategies targeting under-screened populations and eliminating patient-perceived barriers to gastric cancer screening are essential.
本研究旨在确定中国胃癌高发地区 40 岁人群进行胃癌筛查的决定因素。
2021 年 10 月至 2022 年 3 月期间进行了一项匿名、横断面调查。
在中国东南部福建省进行了一项自我管理的在线调查。
无癌症病史、年龄在 40 岁的居住在福建省五个选定城市的人。
胃癌筛查参与情况通过以下问题进行衡量：“您过去是否接受过胃癌筛查？”
共获得 2547 份完整回复。受访者的平均年龄为 47.72±7.20 岁，其中 59.8%为男性。共有 42.6%的参与者报告他们接受过胃癌筛查。多变量逻辑回归分析结果显示，有一级亲属患胃癌（OR=2.02，95%CI：1.58 至 2.59）和对胃癌高易感性（OR=2.03，95%CI：1.58 至 2.59）的参与者是筛查参与的最强促进因素。其他与筛查参与正相关的因素包括年龄 51-60 岁（OR=1.69，95%CI：1.31 至 2.18）、居住在城市地区（OR=1.27，95%CI：1.05 至 1.55）、有胃癌的朋友/邻居/同事（OR=1.30，95%CI：1.07 至 1.58）、慢性胃病史（OR=1.90，95%CI：1.57 至 2.30）、认为费用高（OR=1.28，95%CI：1.01 至 1.61）和医生推荐（OR=1.71，95%CI：1.36 至 2.16）。另一方面，与筛查参与负相关的因素包括感知障碍，即只有出现症状时才需要筛查（OR=0.71，95%CI：0.58 至 0.87）和认为预约进行胃镜筛查既困难又耗时（OR=0.75，95%CI：0.60 至 0.94）。知识水平与筛查参与之间无显著关联。
本研究强调了胃癌筛查的重要个体因素和障碍。针对未筛查人群的策略和消除患者对胃癌筛查的感知障碍至关重要。
