Preferences for the “screen and treat” Strategy of Helicobacter pylori to Prevent Gastric Cancer in Healthy Korean Populations

Abstract

Helicobacter pylori (HP) eradication may reduce the risk of gastric cancer, and professional guidelines recommend eradication based on patients' preference. However, little data exist regarding individual's preference for HP eradication to prevent gastric cancer. We explored healthy Korean populations' preference for HP "screen and treat" strategy and its associated factors. We conducted a cross-sectional survey with 604 healthy adults expected to undergo screening esophagogastroduodenoscopy during routine health checkups. Survey packages-including a decision aid about "screen and treat" strategy for the HP eradication-were sent to the eligible people 1-3weeks before the health checkup. Within the survey package, we first assessed people's knowledge and experience with HP test and treatment, provided the decision aid, and evaluated participants' preference for screening and treatment for HP to prevent gastric cancer. With the provision of the decision aid, most participants (73.7%) opted for the "screen and treat" strategy. Having family member(s) with gastric cancer (adjusted odds ratio (aOR)=2.28; 95% confidence interval (CI), 1.16-4.47), previous treatment history of HP (aOR=2.70; 95% CI, 1.38-5.29), and higher baseline knowledge (aOR=1.16; 95% CI, 1.07-1.26) were significantly associated with accepting the strategy. Most participants (71.4%)-and even individuals who did not choose "screen and treat" strategy-agreed with the provision with the decision aid. Individuals preferred to take the "screen and treat" strategy for the prevention of gastric cancer. Further intervention study is warranted to see if implementation of decisional support would improve decision quality and patient outcomes.