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

Abstract

Objectives 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.Design An anonymous, cross-sectional survey was conducted between October 2021 and March 2022.Setting A self-administered online survey was conducted in Fujian Province in Southeastern China.Participants People aged 40 years living in five selected cities in Fujian Province with no history of cancer.Main outcome measures Gastric cancer screening attendance was measured with the question ‘Have you ever been screened for gastric cancer in the past’.Results 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.Conclusion 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.