Cancer Prevention Recommendations: Impact of Adherence

Barriers to upper gastrointestinal screening among the general population in high-prevalence areas: a cross-sectional study

BACKGROUND

In China, there are large differences between regions in the use of gastroscopies and public awareness of upper gastrointestinal (UGI) screening.

OBJECTIVE

This study investigated the current context and analyzed the barriers that influence UGI screening behavior among the general population in UGI cancer high-prevalence areas.

METHODS

A total of 320 participants anonymously answered an online questionnaire. The rank sum test was used to analyze the difference in the scores of the UGI screening awareness questionnaire among participants with different socio-demographic characteristics. Using the awareness level of UGI screening and gastroscopy as the dependent variable, and the socio-demographic characteristics as the independent variable, simple linear regression and binary logistic regression analysis were used to determine the factors influencing attitudes toward gastroscopy screening. We used Spearman's correlation analysis to examine the correlation between UGI screening awareness level and willingness to undergo a gastroscopy.

RESULTS

There was a correlation between the willingness to undergo gastroscopy and the awareness level of UGI screening (r = 0.243, p < 0.001). Linear regression analysis found that age, type of residence, education level, employment status, monthly income, history of gastroscopy, dietary habits, physical exercise, and convenience in obtaining information were significantly correlated with the awareness level of UGI screening ( p < 0.05). Binary logistic regression analysis found that factors significantly associated with gastric cancer screening behavior include residence, monthly income, and self-perceived health status ( p  < 0.05).

CONCLUSION

It is necessary to improve education about UGI cancer and screening knowledge, with a focus on populations with lower education and income.

Factors associated with meeting cancer prevention guidelines in adults

BACKGROUND

Because much worldwide cancer incidence and mortality is related to modifiable risk factors, many global health organizations provide evidence-based recommendations on healthy weight, diet, and physical activity levels for cancer prevention. Even though adherence to such guidelines is reported to reduce cancer incidence and mortality, this adherence is often suboptimal. Identifying factors related to adherence to the guidelines can suggest interventions to improve health promoting lifestyle behaviors for cancer prevention.

OBJECTIVES

Examine a comprehensive set of potentially predictive factors in meeting American Cancer Society's guidelines for healthy weight, fruits and vegetables intake, and physical activity.

METHODS

Data used in the analysis were from adults aged 18 years and older without a history of a cancer diagnosis who participated in the Health Information National Trends Survey in 2019 (n = 3407). Multivariate logistic regression analyses were used to determine the significant predictors for meeting each of the healthy weight, fruits and vegetables intake, and physical activity guidelines.

RESULTS

Overall adherence to each guideline was low: 39.0% met the physical activity guideline, 30.4% met the healthy weight guideline, and 17.6% met the fruits and vegetables intake guideline. Meeting the healthy body weight guideline was greater in current smokers, females, those who had at least some college education, those who did not have a chronic health condition, and those who had very good self-rated health. Meeting the fruits and vegetables intake guideline was greater in females, those who had very good self-rated health, and those who talked to friends or family members regarding their health. Meeting the physical activity guideline was greater in males, those who had household incomes of at least $50,000, those who did not have a chronic health condition, and those who had very good self-rated health.

CONCLUSIONS

The current analyses identified a unique set of predictors for meeting each guideline among US adults who reported never having been diagnosed with cancer. Based on these findings, interventions related to each guideline should be especially targeted to individuals having characteristics that were less likely to meet them.

CLINICAL RELEVANCE

Findings from the current study can assist health care providers who counsel about cancer prevention in the clinical setting.

Adherence to Nutrition and Physical Activity Cancer Prevention Guidelines and Development of Colorectal Adenoma

Adherence to the American Cancer Society’s (ACS) Nutrition and Physical Activity Cancer Prevention Guidelines is associated with reductions in overall cancer incidence and mortality, including site-specific cancers such as colorectal cancer. We examined the relationship between baseline adherence to the ACS guidelines and (1) baseline adenoma characteristics and (2) odds of recurrent colorectal adenomas over 3 years of follow-up. Cross-sectional and prospective analyses with a pooled sample of participants from the Wheat Bran Fiber (n = 503) and Ursodeoxycholic Acid (n = 854) trials were performed. A cumulative adherence score was constructed using baseline self-reported data regarding body size, diet, physical activity and alcohol consumption. Multivariable logistic regression demonstrated significantly reduced odds of having three or more adenomas at baseline for moderately adherent (odds ratio [OR] = 0.67, 95% confidence intervals [CI]: 0.46–0.99) and highly adherent (OR = 0.50, 95% CI: 0.31–0.81) participants compared to low adherers (p-trend = 0.005). Conversely, guideline adherence was not associated with development of recurrent colorectal adenoma (moderate adherence OR = 1.16, 95% CI: 0.85–1.59, high adherence OR = 1.23, 95% CI: 0.85–1.79).

Gastrointestinal Cancers: Screening and Early Detection

OBJECTIVE

To present an overview of current practices in the screening and early detection of gastrointestinal cancers.

DATA SOURCES

Literature reviews.

CONCLUSION

Screening for gastrointestinal cancers is less than desirable, particularly in underserved populations. There are inadequate methods of screening for early detection of esophageal and gastric cancers.

IMPLICATIONS FOR NURSING PRACTICE

Education of patients is needed to reinforce the importance of screening for gastrointestinal cancers.