Public acceptance and uptake of oesophageal adenocarcinoma screening strategies: A mixed-methods systematic review

Sijben, Jasmijn; Peters, Yonne; Velden, Kim van der; Rainey, Linda; Siersema, Peter D.; Broeders, Mireille J. M.

doi:10.1016/j.eclinm.2022.101367

Cited by 8 publications

(9 citation statements)

References 52 publications

(238 reference statements)

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“…These and previous data (28) are particularly important as we refine screening algorithms to include the use of nonendoscopic modalities for screening (29) as recently endorsed by the ACG (conditional recommendation, very low quality of evidence) (6). A quantitative and qualitative systematic review of 19 studies with 15,249 participants similarly emphasized the general public's high level of interest in EAC screening and provided complementary results to our survey showing strong preference for minimally invasive and highly accurate screening tests (21). These unique insights still need to be tested in a US population.…”

Section: Esophagussupporting

confidence: 63%

“…Surveys were designed using a theoretical model of patient behavior based on social cognitive theory (16) and the theory of reasoned action (17) and adapted from earlier validated cancer screening-based surveys (Figure 1) (18,19). These models are grounded in strong theory and share many of the same constructs as the more recently proposed integrated screening action model (20) which seems to be a useful framework for evaluating esophageal cancer screening (21). This process included input from experts in survey design and survey study methodology, cancer screening, and BE/EAC content.…”

Section: Survey Designmentioning

confidence: 99%

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Patient Knowledge, Risk Perception, and Barriers to Barrett's Esophagus Screening

et al. 2022

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INTRODUCTION: Most patients with esophageal adenocarcinoma (EAC) do not have a previous diagnosis of Barrett's esophagus (BE), demonstrating a failure of current screening practices. An understanding of patient attitudes and barriers is essential to develop and implement interventions to improve BE screening adherence. METHODS:We conducted a Web-based survey of patients aged >50 years with chronic gastroesophageal reflux disease at 3 academic medical centers and 1 affiliated safety net health systems. Survey domains included patient characteristics, endoscopy history, familiarity with screening practices, perceived BE/EAC risk, and barriers to screening. RESULTS:We obtained a response rate of 22.6% (472/2,084) (74% men, mean age 67.9 years). Self-identified race and ethnicity of participants was 66.5% non-Hispanic White, 20.0% non-Hispanic Black, 13.4% other race, and 7.1% Hispanic. Screening for BE was recommended in only 13.2%, and only 5.3% reported previous screening. Respondents had notable gaps in knowledge about screening indications; only two-thirds correctly identified BE risk factors and only 19.5% believed BE screening was needed for gastroesophageal reflux disease. More than 1 in 5 respondents believed they would get BE (31.9%) or EAC (20.2%) but reported barriers to screening. Compared with White respondents, more Black respondents were concerned about getting BE/EAC and interested in screening but report higher barriers to screening.DISCUSSION:Patients at risk for BE, particularly racial and ethnic minorities, are worried about developing EAC but rarely undergo screening and have poor understanding of screening recommendations.

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Section: Esophagussupporting

confidence: 63%

Section: Survey Designmentioning

confidence: 99%

Patient Knowledge, Risk Perception, and Barriers to Barrett's Esophagus Screening

et al. 2022

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“…We involved three representatives of the Dutch advocacy group for people with literacy difficulties (foundation ABC) in the development of the information letter. The FGs followed a semistructured interview guide, which was based on a systematic literature review 18. A complete version of the interview guide is available in online supplemental file 1.…”

Section: Methodsmentioning

confidence: 99%

“…13 15-17 However, the potential influence of socioeconomic factors, social stigma, and involvement of the general practitioner on willingness to be screened for BO/OAC remain largely untouched. 18 We aimed to explore Dutch at-risk individuals' perceptions of screening an at-risk population for BO/OAC. Our secondary aim was to collect their perceptions of novel screening tests, namely: transnasal endoscopy, ingestible cell collection devices, and breath analysis.…”

Section: Open Accessmentioning

confidence: 99%

“…Previous surveys and screening trials suggested that the presence of GORD symptoms and easily accessible test options may play an important role in screening motivation 13 15–17. However, the potential influence of socioeconomic factors, social stigma, and involvement of the general practitioner on willingness to be screened for BO/OAC remain largely untouched 18…”

Section: Introductionmentioning

confidence: 99%

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Dutch individuals’ views of screening for oesophageal cancer: a focus group study

Sijben

Peters

Bas

et al. 2023

BMJ Open Gastroenterol

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ObjectiveScreening for early oesophageal adenocarcinoma (OAC), including its precursor Barrett’s oesophagus (BO), can potentially reduce OAC-related morbidity and mortality. This study explores Dutch at-risk individuals’ views of screening an at-risk population for BO/OAC.DesignWe invited 372 individuals with risk factors for OAC from primary care practices, 73 individuals with surveillance experience, and 221 participants of previous studies (BO/OAC screening trial or survey) to participate in focus groups. Transcripts were inductively and thematically analysed by two independent researchers.ResultsA total of 50 individuals (42% with gastro-oesophageal reflux symptoms) of 50–75 years participated. Themes that were raised included: theme 1 ‘screening intentions’ describing participants’ motivation to be screened (eg, early diagnosis, potential reassurance, physician recommendation, and knowing someone with cancer) or decline screening (eg, anticipated discomfort or suboptimal accuracy of the test); theme 2 ‘risk-based eligibility’ describing the tension between effectiveness (eg, targeting high-risk individuals) and inclusivity (eg, making screening available for everyone); theme 3 ‘distributive justice’, in which the pressure of a potential new screening programme on healthcare resources was discussed; and theme 4 ‘information needs’ describing the perceived lack of information access and individuals’ preference to discuss screening with their general practitioner.ConclusionIndividuals not only expressed high willingness to be screened but also voiced the concern that a new screening programme may pressure limited healthcare resources. If implemented, it is crucial to develop educational materials that meet the public’s information needs and explain the test procedures and eligibility criteria while avoiding stigmatising language.

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Prognostic impact of deprivation on esophagogastroduodenoscopy outcome

Eley,

Hawkes,

Barlow

et al. 2024

Endosc Int Open

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Introduction: Socio-Economic Deprivation has long been associated with many gastrointestinal diseases yet its influence on esophago-gastro-duodenoscopy (EGD) diagnosis has not been evaluated. The aim of this study was to investigate the influence of deprivation on outcomes of EGD irrespective of referral reason. Method: Two-thousand consecutive patients presenting to four Health Boards in Wales from June 2019 were studied retrospectively with deprivation scores calculated using the Wales Indices of Multiple Deprivation (WIMD). Patients were sub-classified into quintiles for analysis (Q1 most, Q5 least Deprived). Results: Inhabitants of the most deprived areas were more likely to be diagnosed with Peptic Ulcer (Q1 7.9%, Q5 4.7%; OR 0.498, p=0.018), Severe Esophagitis (LA4, Q1 2.7% v Q5 0%, OR 0.089, p=0.002), Helicobacter Pylori infection (Q1 5.4%, Q5 1.7%; OR 0.284, p=0.002), but less likely to be diagnosed with Barrett’s Eesophagus (Q1 6.3% v Q5 12.3%, OR 2.146, p=0.004) than those from least deprived areas. New cancer diagnoses numbered 53 and were proportionately higher after Urgent Suspected Cancer (USC, n=35, 4.6%) than routine referral (n=3, 0.6%, p<0.001). Deprivation was associated with more advanced staged cancer (stage III Q1 16.7% v Q5 5.6%, OR 0.997, p=0.006: stage IV Q1 16.7% v Q2 38.9% v Q5 22.2%, OR 0.998, p=0.049). Conclusion: Deprivation was associated with two-fold more peptic ulcer disease, three-fold more Helicobacter Pylori infection, and 12-fold more severe esophagitis, and more advanced cancer stage.

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Public acceptance and uptake of oesophageal adenocarcinoma screening strategies: A mixed-methods systematic review

Cited by 8 publications

References 52 publications

Patient Knowledge, Risk Perception, and Barriers to Barrett's Esophagus Screening

Patient Knowledge, Risk Perception, and Barriers to Barrett's Esophagus Screening

Dutch individuals’ views of screening for oesophageal cancer: a focus group study

Prognostic impact of deprivation on esophagogastroduodenoscopy outcome

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