Pilot study of stomach cancer early detection and prevention with endoscopy (Pilot-SCREEN): Acceptability and feasibility results.

Abstract

332 Background: Gastric cancer (GC) is a serious disease with high mortality rates, particularly among high-risk (HR) groups. Early detection and screening can significantly improve outcomes, yet screening guidelines for GC are lacking in the US. We aimed to examine the feasibility and predictors of uptake of an opportunistic upper endoscopy (EGD) performed at the time of colonoscopy (EGD-SC). Methods: Fifty individuals aged 45-80, who were not scheduled to undergo EGD, had not had EGD in the last 5 years, and were scheduled for colonoscopy at a single academic institution were enrolled. Survey was conducted prior to EGD regarding their health history, beliefs, and knowledge about GC, as well as motivators and barriers to obtaining an EGD. A post-EGD survey was conducted 1-2 weeks after the procedure to evaluate participants preferences and satisfaction. We stratified individuals as high and low risk of developing GC based on their race/ethnicity, immigration status, and family history of GC. Results: Among all individuals contacted, 51.6% expressed interest in participating, and 26.6% were enrolled and received EGD at the time of their colonoscopy. Individuals enrolled had a median age of 56 (45-76), 48% were male, and 56% were categorized as high-risk individuals. The majority of participants had less or no knowledge of GC risk factors, and this was more pronounced in the high-risk compared to the low-risk group (87% vs. 73%). Over 90% of patients in both groups believed that screening would detecting GC earlier and reduce the likelihood of dying. Less than 10% believed GC screening would be embarrassing, painful, invasive, or take too much time (Table 1). The post-EGD survey found that 100% of individuals thought the combined EGD-SC was satisfactory, 90.3% acceptable, 97.6% preferred having the EGD done at the same time as the colonoscopy, 92.7% said they would recommend the combined EGD at time of colonoscopy to a family member, and 73.2% felt that the addition of EGD would want them to get screening more than colonoscopy alone. Conclusions: Conducting an opportunistic EGD during a colonoscopy appears to be a feasible and well-received way to screen for precancerous conditions for gastric cancer. Clinical trial information: NCT05566899 . Perceptions and beliefs about gastric cancer screening. High Risk Low Risk Stomach cancer can be found early by undergoing screening 21 (87.5) 19 (100) Treatments are not as bad if you undergo screening 12 (50.0) 8 (42.1) The best way to find smaller cancer is by undergoing screening 22 (91.7) 18 (100) Screening decreases the chance of dying of stomach cancer 22 (91.7) 17 (94.4) Screening is a way to take care of myself 23 (95.8) 19 (100) Stomach cancer screening is embarrassing 2 (8.3) 0 (0) Having stomach cancer screening would take too much time 0 (0) 1 (5.3) Stomach cancer screening exams may be painful 2 (10.5) 2 (8.7) Having stomach cancer screening would expose me to too much invasive 2 (8.3) 2 (10.5)