Abstract B049: Perceptions of gastric cancer screening in Asian Americans

Abstract

Abstract Background: Endoscopy of the upper gastrointestinal tract is an effective way to screen for gastric cancer (GC) and benefits of screening are evident in countries that have implemented nationwide screening. Despite being disproportionately affected by GC, Asian Americans lack knowledge of GC risk factors and resources to make informed decision on GC screening. Experts recommend shared decision making between providers and patients regarding endoscopy for GC screening. However, we lack decision support tools for providers and patients at high risk for GC. Objective: This qualitative study aims to 1) explore patient experiences and perspectives on GC screening with endoscopy on concepts such as perceived GC risk, risk factors, early detection methods, and healthcare navigation, 2) explore provider knowledge, beliefs, and practice patterns regarding GC screening and GC prevention, and 3) develop a decision aid to support shared decision making for GC screening in the Asian American population. Methods: We interviewed primary care providers [PCP] and gastroenterologists in medical networks in Southern California that primarily serve Asian American communities, and patient populations in these medical networks with an initial focus on Korean and Vietnamese Americans who face the highest risk of GC among Asian Americans. Qualitative data was collected using one-on-one interviews with patients and providers. The interview was then transcribed and coded following reflexive thematic analysis. Results: To date, we have interviewed 6 patients and 5 providers and data collection continues. Several key themes were identified during the interviews: Among patients there is a lack of understanding of Helicobacter pylori (H. pylori) as a risk factor for GC, while dietary factors were frequently perceived as risk factors. Providers found GC screening to be beneficial for Korean and Vietnamese populations, and recommended GC screening simultaneous to screening colonoscopy, to reduce patient burden and cost. Patients who had experience with upper endoscopy found it to be acceptable. On the other hand, patients’ desired costs for upper endoscopy were much lower than market out-of-pocket costs of endoscopy. A preliminary decision aid was developed and edited in response to the results. The decision aid presents educational information including risk of GC in Korean and Vietnamese American relative to the general U.S. population, risk factors of GC, GC screening procedures, and risks and benefits of screening. The decision aid offers opportunity to assess personal attitudes towards GC screening, and allows for patients to indicate their intentions for GC screening for discussion with their providers. The decision aid will be further refined with additional qualitative data. Conclusion: Perceptions towards GC screening is generally positive among Asian patients and providers, but the costs of screening are a concern. Patients need education on H. pylori as a risk factor for GC. Citation Format: Simon Kim, Christie Y. Jeon, Celina Shirazipour. Perceptions of gastric cancer screening in Asian Americans [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B049.