Journal of Clinical Gastroenterology
Volume 40, Issue 7, 2006, Pages 606-611

Acceptance of repeat esophagogastroduodenoscopy to detect gastric cancer in a Chinese immigrant cohort (Article)

Cho A.* , Chaudhry A. , Minsky-Primus L. , Tso A. , Perez-Perez G. , Diehl D. , Marcus S.G. , Gany F.M.
  • a Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States, Center for Health Services Research in Primary Care, Department of Veteran Affairs (152), 508 Fulton St, Durham, NC 27705, United States
  • b Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, MD, United States
  • c Jack D Weiler Hospital, Albert Einstein College of Medicine, New York, NY, United States
  • d Charles B Wang Community Health Center, New York, NY, United States
  • e Department of Medicine, New York University School of Medicine, New York, NY, United States
  • f Department of Surgery, New York University School of Medicine, New York, NY, United States
  • g Division of Gastroenterology, New York University School of Medicine, New York, NY, United States
  • h Center for Immigrant Health, New York University School of Medicine, New York, NY, United States

Abstract

GOAL: To study the feasibility of using repeat esophagogastroduodenoscopy (EGD) to screen for Helicobacter pylori infection and gastric cancer in an Asian immigrant cohort. BACKGROUND: Immigrants in the United States (US) from countries with high per capita rates of gastric cancer remain at higher risk for gastric cancer. The existence of the possibly modifiable risk factor of H. pylori infection and the poor outcomes associated with late-stage disease make screening higher-risk groups with EGD an appealing possibility. It is unknown whether Asian immigrants in the US would accept an EGD-based strategy for gastric cancer screening. STUDY: Cross-sectional study of adult Chinese immigrants in New York City with dyspepsia who underwent EGD in an earlier gastric cancer detection study, who were offered a second EGD four years later. Our main outcome measure was acceptance or refusal of repeat EGD. RESULTS: Seventy-three of the 115 Chinese participants in the earlier study were successfully contacted for this current study. Twenty-three of 73 (32%) underwent repeat EGD. Leading reasons given for declining were lack of symptoms and lack of time. Significantly associated with acceptance of repeat EGD was the belief that EGD will find stomach cancer "nearly always" in someone who has it (P=0.0054; odds ratio=14.0, 2.1 to 94.2 95% confidence interval). CONCLUSIONS: Acceptance of repeat EGD for gastric cancer detection in a cohort of Chinese immigrants was relatively low despite the mitigation of cost and language factors, 2 major barriers to healthcare access. Relocation seemed to be a factor as well. In this population, perceptions of the benefits of EGD may influence acceptance of testing for cancer detection purposes. Copyright © 2006 by Lippincott Williams & Wilkins.

Author Keywords

Primary care Immigrant health Gastric cancer Cancer screening Esophagogastroduodenoscopy Health disparity Helicobacter pylori

Index Keywords

China immigrant Chinese retreatment mass screening human comorbidity middle aged priority journal Aged cancer screening Stomach Neoplasms esophagogastroduodenoscopy Endoscopy, Digestive System prognosis Cross-Sectional Studies Humans health services research Asian Americans male female risk factor Risk Factors high risk population Article major clinical study Dyspepsia Helicobacter Infections adult Helicobacter pylori New York City health care access outcome assessment cohort analysis Emigration and Immigration cancer diagnosis Patient Acceptance of Health Care stomach cancer early diagnosis
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-33747466819&doi=10.1097%2f00004836-200608000-00009&partnerID=40&md5=118a6ee7456db4701b2c832e9afd7387
DOI: 10.1097/00004836-200608000-00009
ISSN: 01920790
Cited by: 2
Original Language: English