Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2023; 15(8): 1751-1760
Published online Aug 27, 2023. doi: 10.4240/wjgs.v15.i8.1751
Knowledge, attitude, and practice of monitoring early gastric cancer after endoscopic submucosal dissection
Xiao-Yun Yang, Cong Wang, Yi-Ping Hong, Ting-Ting Zhu, Lu-Jia Qian, Yi-Bing Hu, Li-Hong Teng, Jin Ding
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 by the 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
ARTICLE HIGHLIGHTS
Research background

Gastric cancer is a prevalent and deadly form of cancer worldwide, particularly in China, where it ranks as the third leading cause of cancer-related deaths. Early gastric cancer (EGC) refers to tumors located in the mucosa or submucosa of the stomach, and endoscopic submucosal dissection (ESD) is the recommended treatment. However, non-curative resection can occur, leading to an increased risk of local recurrence. Therefore, monitoring the recurrence of gastric cancer after ESD is crucial for early detection and improved survival.

Research motivation

Although monitoring gastric cancer recurrence is important, little is known about the knowledge, attitude, and practice (KAP) of EGC survivors regarding this issue. Understanding the KAP of patients can help healthcare practitioners develop strategies to improve monitoring practices and promote early detection of recurrence.

Research objectives

To assess the KAP of EGC survivors after ESD regarding monitoring the recurrence of gastric cancer. Specifically, the study aimed to evaluate KAP related to gastric cancer recurrence, reexamination, and follow-up. Additionally, the study aimed to identify sociodemographic factors associated with monitoring practices.

Research methods

This cross-sectional study was conducted at a hospital in Zhejiang, China and involved 400 EGC survivors who underwent ESD. Participants completed a self-designed questionnaire consisting of 40 questions divided into four categories: Personal information and KAP. The questionnaire scores were calculated and analyzed using statistical methods, including t-tests, χ2 tests, and logistic regression analysis.

Research results

The study found that participants had moderate levels of knowledge, positive attitudes, and moderate levels of practice regarding monitoring gastric cancer recurrence. Knowledge scores were higher among participants from urban areas, with higher education levels, professional occupations, higher family incomes, longer time since the last ESD, and without smoking or alcohol use history. Participants with a longer time since their last ESD and without alcohol consumption had more positive attitudes. Factors associated with good monitoring practices included having medical insurance, longer time since the last ESD, and not smoking or drinking alcohol.

Research conclusions

The study highlights the need to improve the knowledge and monitoring practices of EGC survivors after ESD. Educational interventions and targeted strategies should focus on enhancing patient understanding of the importance of monitoring gastric cancer recurrence and promoting regular reexamination and follow-up. Improving knowledge and attitudes can positively influence monitoring practices and contribute to early detection of gastric cancer recurrence.

Research perspectives

Future research should focus on developing effective educational programs and interventions to improve patient knowledge and awareness of gastric cancer recurrence after ESD.