Abstract
ObjectiveChina have implemented population-based esophageal cancer (EC) screening programs, however, the participant rates were relatively low. This study was conducted to examine the association between cancer prevention knowledge and EC screening participation rates (PRs).MethodsData in the analyses were obtained from a population-based cancer screening program in four provinces in China since 2007. In the course of 2007−2016, participants who were evaluated as high risk for EC and subsequently recommended for endoscopy examination were included in the final analysis. One-way analysis of variance test, Chi-square test and logistic regression analysis were applied.ResultsA total of 28,543 individuals assessed as high-risk population for EC were included in this study, with 13,036 males (45.67%) and 15,507 females (54.33%). The prevalence rates of current smoking and alcohol drinking were higher in males (58.25% and 44.22%, respectively) than in females (5.35% and 4.05%, respectively). Participants of females, and those who had older age, lower income, as well as higher education level and cancer prevention knowledge level were more likely to undergo endoscopy. Multivariable analysis showed that higher cancer prevention knowledge was associated with higher PR for endoscopic screening [adjusted odd ratio (aORQ4/Q1) =1.511, 95% confidence interval (95% CI): 1.398−1.632] among our study subjects. This association between cancer prevention knowledge and compliance with endoscopic screening also tends to be strong within subgroups of males, females, aged below 60 years, aged 60 years and above, and lower level of education (illiterate individuals and those with junior high education or less). ConclusionsOur results displayed a positive relationship between cancer prevention knowledge and PRs for endoscopic screening, implying cancer prevention awareness being an independent influence factor for compliance with EC screening. Promoting public campaigns about comprehensive knowledge of cancer prevention seemed to be a reasonable and effective strategy to improve population PRs for EC screening.
Highlights
Esophageal cancer (EC) was the seventh most common cancer and sixth leading cause of cancer death in the world, with appropriately 570,000 new EC cases and 510,000 EC deaths in 2018 [1]
The analysis showed that a higher cancer prevention knowledge, reflecting a higher awareness towards cancer prevention, was significantly related to an increased participation rates (PRs) for EC screening, and the association was robust after adjusting multiple important confounding factors
We observed that the positive association between cancer prevention knowledge and compliance with EC screening occurred in most subgroups such as males, females, those aged below 60 years and those aged 60 years www.cjcrcn.org
Summary
Esophageal cancer (EC) was the seventh most common cancer and sixth leading cause of cancer death in the world, with appropriately 570,000 new EC cases and 510,000 EC deaths in 2018 [1]. According to International Agency for Research on Cancer (IARC), 53.73% and 55.73% of global EC cases and deaths occurred in China, respectively [1]. Primary prevention is essentially behavioral modification, seeking to control the etiological agents of EC [4], such as smoking and alcohol drinking. In China, the proportions of EC attributed to smoking and alcohol drinking were 18.6% and 19.2% for males, and 1.7% and 3.6% for females according to a pooled analysis targeting Chinese population [5]. In 2010, the prevalence of current smoking was 54.0% for males and 2.6% for females in China and the percentage for alcohol drinking were 57.7% and 14.5%, respectively [6,7]
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