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RESEARCH PRODUCT
How do international gastric cancer prevention guidelines influence clinical practice globally?
Hossam HaickInese PolakaEvita GasenkoRolando HerreroDmitry S. BordinAlexander LinkMarcis LejaMinna KuljuAlinta HegmaneGidi ShaniPeter MalfertheinerPaweł MochalskiRaúl Murillosubject
AdultMaleCancer Researchmedicine.medical_specialtyEpidemiologyPopulationMEDLINEHelicobacter Infections03 medical and health sciencesYoung Adult0302 clinical medicineSDG 3 - Good Health and Well-beingStomach NeoplasmsSurveys and QuestionnairesmedicineHumans030212 general & internal medicinePractice Patterns Physicians'educationEarly Detection of CancerAgedAged 80 and overeducation.field_of_studybiologyHelicobacter pyloribusiness.industryGastric cancer preventionUpper endoscopyPublic Health Environmental and Occupational HealthCancerInternational AgenciesHelicobacter pyloriMiddle Agedmedicine.diseasebiology.organism_classificationPrognosis3. Good healthClinical PracticeVaccinationSurvival RateOncology030220 oncology & carcinogenesisFamily medicinePractice Guidelines as Topic/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_beingFemalebusinessdescription
Clinical guidelines recommend particular approaches, including 'screen-and-treat' strategy for Helicobacter pylori, to prevent gastric cancer. However, little of this is implemented in clinical practice. The aim of the study was to identify barriers to implementation of international guidelines. A web-based questionnaire distributed globally to specialists in the field. Altogether 886 responses from 75 countries were received. Of the responders, 570 (64%) were men of mean age 47 years. There were 606 gastroenterologists and 65 epidemiologists among the responders. Altogether, 79.8% of the responders disagreed that the burden of gastric cancer is a diminishing problem. 'Screen-and-treat' strategy for H. pylori in the responder's country was considered appropriate by 44.4%, inappropriate by 24.3%, with 31.3% being uncertain. Population-based screening for gastric cancer was considered appropriate in the respective home-country by 62.2%, in other areas - but not the home country - by 27.6%, and inappropriate by 10.2%. As a screening tool, upper endoscopy was acceptable by 35.6%, upper X-ray series by 55.3%, pepsinogens by 26.2% and breath-tests by 23.4%; accuracy, cost-effectiveness and feasibility among the tests varied widely. The attitude towards H. pylori vaccination was that 4.6% of the responders were eager to start vaccination immediately, 55.9% were supporting vaccination but considered that more data are required 12% were negative, and 27.6% did not have an opinion. In general, the attitude of the specialists was in line with guidelines, but was not always translated into clinical practice, particularly in the case of 'screen-and-treat' strategy.
year | journal | country | edition | language |
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2020-09-01 | European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) |