Zhongguo quanke yixue (Mar 2024)
Study on the Influencing Factors of Gastric Cancer Based on Opportunistic Screening of Upper Gastrointestinal Cancer in Coastal Area of Northern Jiangsu
Abstract
Background In recent years, screening, early diagnosis and early treatment of upper gastrointestinal cancer have been successively carried out in various provinces and cities in China. At present, there are few studies on the screening results of upper gastrointestinal cancer and influencing factors of gastric cancer in coastal area of northern Jiangsu. Objective To analyze the influencing factors of gastric cancer based on the results of opportunistic screening for upper gastrointestinal cancer in rural population in coastal areas of northern Jiangsu, so as to provide a reference for the development of relevant prevention and control strategies. Methods A total of 8 564 rural subjects at high risk for upper gastrointestinal cancer admitted to the outpatient department of gastroenterology of the Affiliated Lianyungang Hospital of Xuzhou Medical University and received gastroscopy screening from January 2021 to December 2022 were selected, and divided into the gastric cancer group (n=183) and benign gastric disease group (n=366) after matching according to age (±2 years) and gender (1∶2) based on the screening results. The baseline data of the subjects were collected, the cancer detection rate and cancer early diagnosis rate were calculated. Multivariate Logistic regression analysis was used to explore the influencing factors of gastric cancer in rural population in coastal area of northern Jiangsu. Results A total of 521 patients with upper gastrointestinal neoplastic lesions were detected, including 183 patients with gastric (including cardia) cancer, with a detection rate of 2.14% (183/8 564) ; and 46 patients with early gastric (including cardia) cancer, with the early diagnosis rate of 25.14% (46/183) . There was no significant difference in the distribution of different categories of gastric neoplastic lesions in different genders and ages (P>0.05) . The detection rate of gastric (including cardia) neoplastic lesions in males (5.14%, 195/3 795) was higher than females (2.05%, 98/4 769) , and the difference was statistically significant (χ2=60.807, P<0.001) . There were significant differences in the detection rate of gastric (including cardia) neoplastic lesions among different age groups (χ2=163.216, P<0.001) and early diagnosis rate of gastric cancer among different age groups (χ2=69.349, P<0.001) , among which the early diagnosis rate was the highest in the group of 40-49 years (37.50%) and the lowest in the group over 80 years (10.53%) . Multivariate Logistic regression analysis showed that junior high school education or below (OR=4.001, 95%CI=2.029-7.890, P<0.001) , smoking (OR=3.710, 95%CI=2.127-6.470, P<0.001) , salty taste (OR=1.777, 95%CI=1.067-2.957, P=0.027) , frequent spicy diet (OR=2.147, 95%CI=1.297-3.556, P=0.003) , preference for red meat (OR=1.787, 95%CI=1.018-3.139, P=0.043) , frequent consumption of leftovers (OR=2.452, 95%CI=1.538-3.912, P<0.001) , irregular diet (OR=2.420, 95%CI=1.420-4.124, P=0.001) and helicobacter pylori (H. pylori) positive/previously positive (OR=3.785, 95%CI=2.394-5.984, P<0.001) were risk factors for gastric cancer in rural population, while regular physical exercise (OR=0.598, 95%CI=0.359-0.996, P=0.048) and frequent consumption of fresh fruits (OR=0.531, 95%CI=0.328-0.860, P=0.010) were protective factors for gastric cancer in rural population. Conclusion Opportunistic screening of upper gastrointestinal cancer is beneficial for the detection of upper gastrointestinal cancer in Coastal Area of Northern Jiangsu. Junior high school education and below, smoking, multiple unhealthy food habits and H. pylori positive/previously positive are risk factors for gastric cancer in rural population. Future efforts should focus on improving the awareness of gastric cancer prevention among rural males and elderly population in the region.
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