High-risk population's knowledge of risk factors and warning symptoms and their intention toward gastric cancer screening in Southeastern China

Abstract

BackgroundAs the incidence of gastric cancer (GC) increases sharply in adults aged over 40 years, screening of this high-risk population is important. This study aimed to explore knowledge level of GC related risk factors and symptoms, and to identify influencing factors associated with intention toward GC screening among people aged 40 years old and above in China.MethodsA cross-sectional, web-based survey was conducted among people aged 40 years old and above between October 2021 and March 2022 in Southeastern China. The participants' knowledge was assessed by a series of questions about risk factors (24-item scale) and warning symptoms (14-item scale).ResultsA total of 2547 complete responses were received. The mean age was 47.72 (±7.20) years and near 60% were male. Respondents had a moderate level of knowledge about risk factors and warning symptoms of GC. The total mean knowledge score was 23.9 (±9.8) out of a possible score of 38. Majority (80%) of respondents reported intention to be screened for GC in the next 5 years. The most influential predictors of screening intention were income level (OR = 2.13, 95% CI: 1.36–3.32), perceived benefits (OR = 1.99, 95% CI: 1.33–2.73), perceived severity (OR = 1.68, 95% CI: 1.20–2.34), ever took GC screening (OR = 1.63, 95% CI: 1.28–2.08), perceived poor overall health (OR = 1.59, 95% CI: 1.19–2.11), and perceived barriers (OR = 1.56, 95% CI: 1.17–2.09). Other significant factors were ever diagnosed with chronic gastric diseases, total knowledge score, and cues-to-action. The major reasons for not willing to take screening were “endoscopy is uncomfortable” (29.6%), “worry about screening results” (23.6%), and “have no symptoms” (21.3%).ConclusionHigh-risk population aged 40 years and above expressed high intention to receive GC screening. Intervention to improve health promotion and reduce the barriers to uptake of GC screening among high-risk populations in China is warranted.

Determinants of gastric cancer screening attendance in Southeastern China: a cross-sectional study

“…Various studies have consistently reported low knowledge about gastric cancer as a barrier to timely screening and treatment 47 48. Our previous study found that a high level of knowledge about gastric cancer and screening was associated with a stronger intention to undergo screening 27. However, the current study did not find a significant association between knowledge levels and screening participation.…”

“…However, population-level gastric cancer screening studies in China are limited. We recently conducted a study exploring gastric cancer screening in a high-risk population (aged ≥40 years and living in a high-risk region) in Southeastern China, which revealed a high (80%) proportion of intention to be screened for gastric cancer 27. However, an intention–action gap remains that warrants further investigation.…”

Anticipatory anxiety and participation in cancer screening. A systematic review

“…Another study reported that anxiety about being ‘checked’ for oral cancer was negatively associated with screening intention, however, it was not clear if this anxiety was related to the results or the procedure 99 . In one study conducted in South Eastern China, nearly one quarter of people reported worry about screening results as a reason not to screen for gastric cancer 39 …”

“…Thirteen studies reported on anticipatory anxiety as a barrier to cancer screening or intention, without empirically testing the relationship. [28][29][30][31][32][33][34][35][36][37][38][39][40] The frequency at which fear of and worry about a cancer diagnosis, or the screening procedure itself were reported as a barrier or deterrent to cancer screening varied greatly across studies.…”

“…Two studies showed that people with higher levels of cancer worry were more willing to undergo a screening test for oesophageal and gastric cancer, respectively. 39,98 Another study reported that anxiety about being 'checked' for oral cancer was negatively associated with screening intention, however, it was not clear if this anxiety was related to the results or the procedure. 99 In one study conducted in South Eastern China, nearly one quarter of people reported worry about screening results as a reason not to screen for gastric cancer.…”