Participation Rate Of Endoscopic Screening,detection Rate Of Lesions And Their Influencing Factors Among High-risk Population For Gastric Cancer In Huai River Basin Of Anhui Province From 2013 To 2018

Objective Gastric cancer is a common malignant tumor worldwide,and gastric cancer screening and early diagnosis and treatment are recognized preventive and control measures for gastric cancer.It is particularly important to improve the participation rate of gastric cancer endoscopic screening so as to detect and treat gastric cancer and precancerous lesions at an early stage.In this study,we selected a large sample of data from 2013-2018 among the high-risk population of gastric cancer in the Huaihe River basin of Anhui Province for analysis,aiming to investigate the factors influencing the participation rate of endoscopic screening and detection rate of lesions among the high-risk population of gastric cancer,and provide a reference basis for better gastric cancer screening in the Huaihe River basin in the future.MethodsThe Huaihe River basin Cancer Early Diagnosis and Treatment Project was carried out from 2013 to 2018 in six regions of Anhui Province: Bengbu,Huainan,Chuzhou,Luan,Suzhou and Fuyang.Using a whole-group sampling method,townships or villages with high morbidity and mortality rates were selected as target populations for permanent residents aged 40-69 to conduct a survey of health factors and assess the risk of gastric cancer.Residents who are assessed to be at high risk of stomach cancer and meet the criteria for endoscopic screening are invited to undergo free endoscopic screening at the hospitals designated by the project and the results are collected.A multi-factor unconditional logistic regression model was used to analysis the factors associated with the participation rate of endoscopic screening and detection rate of lesions among the high-risk population of gastric cancer.ResultsA total of 70 927 people at high risk of gastric cancer were included,of whom 32 170 received endoscopic screening,and the overall participation rate was 45.36%.Significant differences in participation rates were found across different years(χ~2= 651.193,P<0.001)and region(χ~2= 4 799.975,P<0.001).Multi-factor logistic regression analysis showed that female(OR=1.26,95%CI: 1.21-1.31),older age(50-59 years,OR=1.29,95%CI:1.24-1.34;60-69 years,OR=1.36,95%CI: 1.30-1.42),college education or above(OR=1.67,95%CI: 1.47-1.91),divorced/widowed(OR=1.22,95%CI: 1.13-1.31),high annual family income(>10 000-30 000 yuan,OR=1.45,95%CI: 1.39-1.50;>30 000-50000 yuan,OR=1.42,95%CI: 1.35-1.49;>50 000 yuan,OR=1.24,95%CI: 1.16-1.31),drinking untreated water(shallow water,OR=1.31,95%CI: 1.25-1.36;deep well/spring water,OR=1.31,95%CI: 1.25-1.38),nonsmoking(OR=1.27,95%CI: 1.21-1.33),nondrinking(OR=1.19,95%CI: 1.13-1.24),high frequency of pickled and sun-dried food intake(OR=1.31,95%CI: 1.26-1.36),history of digestive system disease(1 type,OR=1.32,95%CI: 1.27-1.37;2 type,OR=1.95,95%CI: 1.82-2.08;3 or more types,OR=2.52,95%CI: 2.21-2.86)and a family history of gastric cancer(OR=1.26,95%CI:1.17-1.36)had higher participation rates in endoscopic screening,and those with lean body mass index(OR=0.85,95%CI: 0.74-0.98)and overweight body mass index(OR=0.96,95%CI: 0.93-0.99)had lower participation rates in endoscopic screening.A total of 32 170 people in the high-risk group for gastric cancer participated in endoscopic pathology screening,with 1 124 cases of gastric cancer and precancerous lesions examined and an overall detection rate of 3.49%.Significant differences in detection rate of lesions were found across different years(χ~2=88.503,P<0.001)and region(χ~2=251.139,P<0.001).Multi-factor logistic regression showed that the detection rate of gastric cancer and precancerous lesions was lower in female(OR=0.60,95%CI: 0.52-0.69),nonsmoking(OR=0.84,95%CI: 0.72-0.98)had lower detection rate of gastric cancer and precancerous lesions,older age(50-59 years,OR=1.53,95%CI: 1.28-1.83;60-69 years,OR=2.44,95%CI: 2.06-2.89)had higher detection rate of gastric cancer and precancerous lesions.ConclusionsThe participation rate of endoscopic screening among the high-risk group of gastric cancer in the Huaihe River basin of Anhui Province still needs to be improved.The year of participation,participation area,gender,age,education level,marital status,average annual household income,body mass index,water consumption,smoking,alcohol consumption,frequency of pickled food intake,history of digestive system diseases and family history of gastric cancer were associated with the participation rate of endoscopic screening.The detection rate of gastric cancer and precancerous lesions by endoscopic screening is high among the high-risk group of gastric cancer in the Huaihe River basin of Anhui Province.We should focus on the screening of gastric cancer in the high-risk group of gastric cancer in the Huaihe River basin,where gender,age and smoking are the main factors affecting the detection rate of lesions by endoscopic screening.