Study On The Surveillance Content Of Gastric Cancer Risk Factors

Objective:As a common malignancy,gastric cancer has high mortality,poor prognosis and severe disease burden,and has become an important public health problem in China.The surveillance of gastric cancer is the first step and important basis for the prevention and control of gastric cancer.Surveilling the risk factors of gastric cancer is of great significance for the effective prevention and control of gastric cancer.China has not yet carried out specific surveillance of the risk factors of malignant tumors.This study is based on the principle of taking into account the importance,necessity,and feasibility,and discusses the main content of surveillance of gastric cancer risk factors applicable to our country's population to identify high-risk groups of gastric cancer,which provides a reference of public health policy.Methods:Firstly,a systematic evaluation method combining quantitative and qualitative methods was used to collect and sort out the existing Chinese and English literature on risk factors of gastric cancer,and to comb out the risk factors affecting the incidence of gastric cancer in Chinese population as the basic factors for monitoring the risk factors of gastric cancer.Quantitative systematic evaluation methods were used for the original literature with better heterogeneity,namely Meta analysis to explore the OR associated with risk factors and the incidence of gastric cancer;qualitative studies were used to provide the ranges of OR values for the original literature with poor heterogeneity.The OR or OR range obtained by qualitative and quantitative systematic evaluation methods were taken as the measurement basis for the importance of the risk factors for the surveillance of gastric cancer risk factors.Secondly,the Delphi method is used to judge the necessity and feasibility of the surveillance of risk factors according to the expertise and practical experience of authoritative experts.Establishing the surveillance of gastric cancer risk factors according to their importance,necessity and feasibility.Results:Through literature searches,research literature on the risk factors for gastric cancer published in China from January 1,1997 to December 31,2016 was collected.A total of 5439 articles were retrieved,of which 5075 were in Chinese and 364 were in English,and 13 articles were manually traced back.After eliminating duplicates,inconsistent content,unusable data,repeated publication,review categories,discrepancies in the study population,and low quality scores,a total of 71 Chinese and English literature were included.The 71 articles included six categories of behavioral and lifestyle factors,genetic factors,disease factors,psychosocial factors,physical and chemical factors,and drug factors,a total of 54 factors,as a content framework for the surveillance of gastric cancer risk factors.The OR value and OR range of risk factors are used as a measure of the importance of this factor in surveillance.Using the Delphi method,a total of 20 experts in related fields were invited to make use of the expert's expertise and practical experience to evaluate the necessity and feasibility of 54 factors being included in the surveillance.A total of two rounds of expert consultations were conducted.The first round of consultations had an expert positive coefficient El of 86.96%,an expert authority index Crl of 0.781,and a necessity score expert coordination coefficient W of 0.450(P<0.001).The feasibility score expert coordination coefficient W was 0.388(P<0.001).The second-round consultation expert's positive coefficient E2 is 90%,and the expert authority coefficient Cr2 is 0.891,and a necessity score expert coordination coefficient W of 0.469(P<0.001).The feasibility score expert coordination coefficient W was 0.469(P<0.001).The factors which"necessity" and "feasibility" scores were less than 2.5 points,and the coefficient of variation were more than 0.5 points and the full-scale ratio of less than 20%were excluded.In combination with expert open opinions,the five categories of lifestyle factors,genetic factors,disease factors,psychosocial factors,and drug factors were finalized and a total of 33 factors were included in the monitoring of gastric cancer.Conclusion:In this study,the systemic reviews method and Delphi method were used to construct the monitoring of risk factors for gastric cancer.The qualitative,quantitative systematic reviews,multi-stage expert consultation,open expert opinions,and the importance,necessity,and feasibility aspects were taken into consideration to estabolish the monitoring system.The monitoring system basically established five categories including behavior and lifestyle factors,genetic factors,disease factors,psychosocial factors and drug factors.Each category has 25,2,3,2,1 and a total of 33 monitoring factors.The risk factors of gastric cancer monitoring provide a reference basis for solving urgent cancer prevention and control,and improving the surveillance for chronic diseases risk factors.