Patient Preference and Adherence (Mar 2023)

Willingness to Undergo Gastroscopy for Early Gastric Cancer Screening and Its Associated Factors During the COVID-19 Pandemic – A Nationwide Cross-Sectional Study in China

  • Ma K,
  • Chen X,
  • Xiang X,
  • Mao X,
  • Zhu N,
  • Wang T,
  • Ye S,
  • Wang X,
  • Deng M

Journal volume & issue
Vol. Volume 17
pp. 505 – 516

Abstract

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Kejia Ma,1,2 Xuejie Chen,1,2 Xin Xiang,3 Xueyi Mao,3 Ningxin Zhu,1,2 Tianyu Wang,1,2 Shuyu Ye,1,2 Xiaoyan Wang,1,2,* Minzi Deng1,2,* 1Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China; 2Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha, Hunan, People’s Republic of China; 3Xiangya Medical College of Central South University, Changsha, Hunan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaoyan Wang; Minzi Deng, Department of Gastroenterology, The Third Xiangya Hospital, Central South University, No. 138 Tongzipo Road, Changsha, Hunan, People’s Republic of China, Tel +86 139 7488 9301 ; +86 137 8615 2169, Email [email protected]; [email protected]: This study aimed to investigate the willingness of Chinese adults aged 40 years and older to undergo gastroscopy for gastric cancer (GC) screening during the COVID-19 pandemic in 2020. The secondary purpose was to identify factors influencing willingness to undergo gastroscopy.Methods: A cross-sectional questionnaire survey was conducted in selected cities and counties from nine provinces in China using a multi-stage sampling approach. A multivariate logistic regression model was used to determine the independent predictors of willingness to undergo gastroscopy.Results: This study included 1900 participants, and 1462 (76.95%) responded that they would undergo gastroscopy for GC screening. Participants of younger age, from the eastern region, living in an urban area, with higher educational levels, with Helicobacter pylori (H. pylori) infection, or with precancerous stomach lesions, were more willing to undergo gastroscopy. The top four reasons to reject gastroscopy were fear of pain or discomfort, worry about a possible devastating test result, no symptoms in self-feeling, and concern about the high expense. Of all those who would reject gastroscopy for GC screening, 36.76% (161/438) would be willing to accept painless gastroscopy, while 24.89% (109/438) would be willing to undergo gastroscopy screening if higher medical reimbursement rates were available. Participants considered that gastroscopy was a relatively fearful and unknown procedure, accompanied by high risks and benefits compared to all other life events.Conclusion: In general, 76.95% of participants over 40 years old were willing to undergo gastroscopy for GC screening in China during the COVID-19 pandemic. Participants’ willingness to undergo GC screening increased due to medical resource constraints and increased interest in their health. Individuals with H. pylori infection are more likely to undergo gastroscopy, whereas old age individuals, those with lower educational levels, and those living in rural areas are more likely to reject gastroscopy.Keywords: gastrointestinal tumors, endoscopy, public health, early screening, questionnaire

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