Yang XY, Wang C, Hong YP, Zhu TT, Qian LJ, Hu YB, Teng LH, Ding J. Knowledge, attitude, and practice of monitoring early gastric cancer after endoscopic submucosal dissection. World J Gastrointest Surg 2023; 15(8): 1751-1760 [PMID: 37701694 DOI: 10.4240/wjgs.v15.i8.1751]
Corresponding Author of This Article
Jin Ding, MD, Associate Professor, Chief Physician, Department of Gastroenterology and Hepatology, The Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No. 365 Renmin East Road, Jinhua 321000, Zhejiang Province, China. jhdingjin@zju.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xiao-Yun Yang, Cong Wang, Yi-Ping Hong, Ting-Ting Zhu, Yi-Bing Hu, Li-Hong Teng, Jin Ding, Department of Gastroenterology and Hepatology, The Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
Lu-Jia Qian, Department of Pathology, The Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
Author contributions: Yang XY carried out the studies, participated in collecting data, and drafted the manuscript; Wang C, Hong YP, and Zhu TT proposed the questionnaire and revised it; Qian LJ was the pathologist who participated in collecting pathological data; Hong YP and Teng LH performed the statistical analysis and participated in its design; Ding J reviewed the literature and contributed to revising the article; and all authors read and approved the final manuscript.
Supported bythe Basic Public Welfare Research Program of Zhejiang Province, No. LGF19H160022; and the Key Project of Jinhua Social Development, No. 2018-3-001f.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Jinhua Hospital [Approval No. (2022) Lunshendi (211)].
Informed consent statement: All participants provided oral informed consent.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin Ding, MD, Associate Professor, Chief Physician, Department of Gastroenterology and Hepatology, The Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No. 365 Renmin East Road, Jinhua 321000, Zhejiang Province, China. jhdingjin@zju.edu.cn
Received: February 16, 2023 Peer-review started: February 16, 2023 First decision: April 27, 2023 Revised: May 22, 2023 Accepted: June 13, 2023 Article in press: June 13, 2023 Published online: August 27, 2023 Processing time: 189 Days and 23.1 Hours
Abstract
BACKGROUND
Early gastric cancer (EGC) is typically treated with endoscopic submucosal dissection (ESD). However, recurrence may occur after ESD, requiring surveillance.
AIM
To examine the knowledge, attitude, and practice (KAP) of EGC survivors following ESD regarding gastric cancer recurrence.
METHODS
This cross-sectional study was conducted between June 1, 2022 and October 1, 2022 in Zhejiang, China. A total of 400 EGC survivors who underwent ESD at the Affiliated Jinhua Hospital, Zhejiang University School of Medicine participated in this study. A self-administered questionnaire was developed to assess KAP monitoring gastric cancer after ESD.
RESULTS
The average scores for KAP were 3.34, 23.76, and 5.75 out of 5, 30, and 11, respectively. Pearson correlation analysis revealed positive and significant correlations between knowledge and attitude, knowledge and practice, and attitude and practice (r = 0.405, 0.511, and 0.458, respectively; all P < 0.001). Multivariate logistic regression analysis showed that knowledge, attitude, 13-24 mo since the last ESD (vs ≤ 12 mo since the last ESD), and ≥ 25 mo since the last ESD (vs ≤ 12 mo since the last ESD) were independent predictors of proactive practice (odds ratio = 1.916, 1.253, 3.296, and 5.768, respectively, all P < 0.0001).
CONCLUSION
EGC survivors showed inadequate knowledge, positive attitude, and poor practices in monitoring recurrences after ESD. Adequate knowledge, positive attitude, and a longer time since the last ESD were associated with practice.
Core Tip: This is the first study to examine the knowledge, attitude, and practice regarding monitoring of gastric cancer recurrence after endoscopic submucosal dissection (ESD). Participants’ average knowledge, attitude, and practice scores indicated inadequate knowledge, good attitude, and poor practice. Significant and positive correlations were found between knowledge and attitude, knowledge and practice, and attitude and practice. Sufficient knowledge, a positive attitude, and at least 12 mo since the last ESD were independent predictors for correct practice. The lack of knowledge and insufficient practice in monitoring cancer recurrence may explain the 89.2% of pathologically confirmed early tumors after ESD.
