Health-seeking behavior and barriers to treatment of patients with upper gastrointestinal cancer detected by screening in rural China: real-world evidence from the ESECC trial
Background: To fully realize efficacy in cancer screening, timely and appropriate treatment for participants with malignant lesions is critical. However, the health-seeking behavior of patients with upper gastrointestinal (G.I.) cancer identified in population-level screening programs in China is un...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-07-01
|
| Series: | The Lancet Regional Health. Western Pacific |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666606521000900 |
| _version_ | 1798035062270197760 |
|---|---|
| author | Hui Wang Zhen Liu Chuanhai Guo Mengfei Liu Yu He Hongrui Tian Yaqi Pan Fangfang Liu Ying Liu Zhe Hu Huanyu Chen Zhonghu He Yang Ke |
| author_facet | Hui Wang Zhen Liu Chuanhai Guo Mengfei Liu Yu He Hongrui Tian Yaqi Pan Fangfang Liu Ying Liu Zhe Hu Huanyu Chen Zhonghu He Yang Ke |
| author_sort | Hui Wang |
| collection | DOAJ |
| description | Background: To fully realize efficacy in cancer screening, timely and appropriate treatment for participants with malignant lesions is critical. However, the health-seeking behavior of patients with upper gastrointestinal (G.I.) cancer identified in population-level screening programs in China is unknown. Methods: A community-based real-world investigation was conducted with 136 upper G.I. cancer patients detected in a large screening cohort in an area of high-risk for upper G.I. cancer in China. Using local medical claims data and semi-structured face-to-face interview, we collected information regarding the clinical treatment regimen and factors which result in the lack of timely and appropriate treatment. Findings: The treatment records for 133 upper G.I. cancer patients were acquired. Among these, 48 (36•09%) patients did not receive treatment within three months of initial diagnosis, and treatment of early-stage cancer was more likely to be delayed. Sixteen patients did not seek further diagnostic testing due to their low health-awareness and socio-economic status. Another 20 participants proactively sought further diagnostic evaluation in health care facilities but were prevented from receiving further treatment due to low sensitivity of given diagnostic test(s), failure to recognize the significance of screening results, and/or lack of basic knowledge of diagnosis and treatment for early cancer on the part of clinicians. The treatment regimen offered to patients depended largely on the level of health care facilities they visited, and non-medical factors were the main reasons for choice of health care facilities. Interpretation: A coordinated, system-based management strategy is urgently needed to support the design of upper G.I. cancer screening programs in rural populations in China. Funding: The Charity Project of the National Ministry of Health (201202014), the National Key R & D Program of China (2016YFC0901404), the National Science & Technology Fundamental Resources Investigation Program of China (2019FY101102), and the National Natural Science Foundation of China (82073626). |
| first_indexed | 2024-04-11T20:52:59Z |
| format | Article |
| id | doaj.art-a046d907d7684daab6ede447f2a814ce |
| institution | Directory Open Access Journal |
| issn | 2666-6065 |
| language | English |
| last_indexed | 2024-04-11T20:52:59Z |
| publishDate | 2021-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Western Pacific |
| spelling | doaj.art-a046d907d7684daab6ede447f2a814ce2022-12-22T04:03:47ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652021-07-0112100181Health-seeking behavior and barriers to treatment of patients with upper gastrointestinal cancer detected by screening in rural China: real-world evidence from the ESECC trialHui Wang0Zhen Liu1Chuanhai Guo2Mengfei Liu3Yu He4Hongrui Tian5Yaqi Pan6Fangfang Liu7Ying Liu8Zhe Hu9Huanyu Chen10Zhonghu He11Yang Ke12Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, People's Republic of ChinaKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, People's Republic of ChinaKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, People's Republic of ChinaKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, People's Republic of ChinaDepartment of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UKKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, People's Republic of ChinaKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, People's Republic of ChinaKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, People's Republic of ChinaKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, People's Republic of ChinaKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, People's Republic of ChinaKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, People's Republic of ChinaKey laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China; Corresponding author. Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Beijing, 100142, P.R. China, Tel: +86-10-88196762Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China; Corresponding author. Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, #52 Fucheng Rd, Beijing, 100142, P.R. China, Tel: +86-10-88196762Background: To fully realize efficacy in cancer screening, timely and appropriate treatment for participants with malignant lesions is critical. However, the health-seeking behavior of patients with upper gastrointestinal (G.I.) cancer identified in population-level screening programs in China is unknown. Methods: A community-based real-world investigation was conducted with 136 upper G.I. cancer patients detected in a large screening cohort in an area of high-risk for upper G.I. cancer in China. Using local medical claims data and semi-structured face-to-face interview, we collected information regarding the clinical treatment regimen and factors which result in the lack of timely and appropriate treatment. Findings: The treatment records for 133 upper G.I. cancer patients were acquired. Among these, 48 (36•09%) patients did not receive treatment within three months of initial diagnosis, and treatment of early-stage cancer was more likely to be delayed. Sixteen patients did not seek further diagnostic testing due to their low health-awareness and socio-economic status. Another 20 participants proactively sought further diagnostic evaluation in health care facilities but were prevented from receiving further treatment due to low sensitivity of given diagnostic test(s), failure to recognize the significance of screening results, and/or lack of basic knowledge of diagnosis and treatment for early cancer on the part of clinicians. The treatment regimen offered to patients depended largely on the level of health care facilities they visited, and non-medical factors were the main reasons for choice of health care facilities. Interpretation: A coordinated, system-based management strategy is urgently needed to support the design of upper G.I. cancer screening programs in rural populations in China. Funding: The Charity Project of the National Ministry of Health (201202014), the National Key R & D Program of China (2016YFC0901404), the National Science & Technology Fundamental Resources Investigation Program of China (2019FY101102), and the National Natural Science Foundation of China (82073626).http://www.sciencedirect.com/science/article/pii/S2666606521000900 |
| spellingShingle | Hui Wang Zhen Liu Chuanhai Guo Mengfei Liu Yu He Hongrui Tian Yaqi Pan Fangfang Liu Ying Liu Zhe Hu Huanyu Chen Zhonghu He Yang Ke Health-seeking behavior and barriers to treatment of patients with upper gastrointestinal cancer detected by screening in rural China: real-world evidence from the ESECC trial The Lancet Regional Health. Western Pacific |
| title | Health-seeking behavior and barriers to treatment of patients with upper gastrointestinal cancer detected by screening in rural China: real-world evidence from the ESECC trial |
| title_full | Health-seeking behavior and barriers to treatment of patients with upper gastrointestinal cancer detected by screening in rural China: real-world evidence from the ESECC trial |
| title_fullStr | Health-seeking behavior and barriers to treatment of patients with upper gastrointestinal cancer detected by screening in rural China: real-world evidence from the ESECC trial |
| title_full_unstemmed | Health-seeking behavior and barriers to treatment of patients with upper gastrointestinal cancer detected by screening in rural China: real-world evidence from the ESECC trial |
| title_short | Health-seeking behavior and barriers to treatment of patients with upper gastrointestinal cancer detected by screening in rural China: real-world evidence from the ESECC trial |
| title_sort | health seeking behavior and barriers to treatment of patients with upper gastrointestinal cancer detected by screening in rural china real world evidence from the esecc trial |
| url | http://www.sciencedirect.com/science/article/pii/S2666606521000900 |
| work_keys_str_mv | AT huiwang healthseekingbehaviorandbarrierstotreatmentofpatientswithuppergastrointestinalcancerdetectedbyscreeninginruralchinarealworldevidencefromtheesecctrial AT zhenliu healthseekingbehaviorandbarrierstotreatmentofpatientswithuppergastrointestinalcancerdetectedbyscreeninginruralchinarealworldevidencefromtheesecctrial AT chuanhaiguo healthseekingbehaviorandbarrierstotreatmentofpatientswithuppergastrointestinalcancerdetectedbyscreeninginruralchinarealworldevidencefromtheesecctrial AT mengfeiliu healthseekingbehaviorandbarrierstotreatmentofpatientswithuppergastrointestinalcancerdetectedbyscreeninginruralchinarealworldevidencefromtheesecctrial AT yuhe healthseekingbehaviorandbarrierstotreatmentofpatientswithuppergastrointestinalcancerdetectedbyscreeninginruralchinarealworldevidencefromtheesecctrial AT hongruitian healthseekingbehaviorandbarrierstotreatmentofpatientswithuppergastrointestinalcancerdetectedbyscreeninginruralchinarealworldevidencefromtheesecctrial AT yaqipan healthseekingbehaviorandbarrierstotreatmentofpatientswithuppergastrointestinalcancerdetectedbyscreeninginruralchinarealworldevidencefromtheesecctrial AT fangfangliu healthseekingbehaviorandbarrierstotreatmentofpatientswithuppergastrointestinalcancerdetectedbyscreeninginruralchinarealworldevidencefromtheesecctrial AT yingliu healthseekingbehaviorandbarrierstotreatmentofpatientswithuppergastrointestinalcancerdetectedbyscreeninginruralchinarealworldevidencefromtheesecctrial AT zhehu healthseekingbehaviorandbarrierstotreatmentofpatientswithuppergastrointestinalcancerdetectedbyscreeninginruralchinarealworldevidencefromtheesecctrial AT huanyuchen healthseekingbehaviorandbarrierstotreatmentofpatientswithuppergastrointestinalcancerdetectedbyscreeninginruralchinarealworldevidencefromtheesecctrial AT zhonghuhe healthseekingbehaviorandbarrierstotreatmentofpatientswithuppergastrointestinalcancerdetectedbyscreeninginruralchinarealworldevidencefromtheesecctrial AT yangke healthseekingbehaviorandbarrierstotreatmentofpatientswithuppergastrointestinalcancerdetectedbyscreeninginruralchinarealworldevidencefromtheesecctrial |