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Lu J, Wang Q, Zhang H, Liu J, Ren J, Fan J, Gong J, Sui Y, Chen X. Analysis of endoscopic and pathological features of 6961 cases of gastric cancer. Sci Rep 2024; 14:7159. [PMID: 38532198 PMCID: PMC10965891 DOI: 10.1038/s41598-024-58018-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/25/2024] [Indexed: 03/28/2024] Open
Abstract
Gastric cancer (GC) stage and tissue differentiation affect treatment efficacy and prognosis, highlighting the importance of understanding the risk factors that affect these parameters. Therefore, this study analyzed risk factors affecting the GC stage and differentiation and the relationships between the cancer site and the sex and age of the patient. We collected clinical data from 6961 patients with GC, including sex, age, endoscopic lesion location, and pathological differentiation. Patients were grouped based on GC stage (early or advanced), differentiation (well or poorly differentiated), and lesion site (upper stomach [cardia and fundus], middle stomach [gastric body], and lower stomach [gastric antrum]). Differences in sex, age, location, stage, and degree of differentiation were assessed based on these groupings. Univariate analysis revealed that the disease location and differentiation significantly differed based on the GC stage (P < 0.05), whereas sex, age, site, and stage significantly differed based on GC differentiation (P < 0.05). A multivariate analysis confirmed these factors as independent risk factors affecting GC. Moreover, lesion sites significantly differed between sexes (P < 0.05) and among age groups (P < 0.05). Although the effects of family history, lifestyle, and Helicobacter pylori infection status of the patients were not considered, this single-center retrospective study established independent risk factors for GC.Trial registration ChiCTR2200061989.
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Affiliation(s)
- Junhui Lu
- Faculty of Graduate Studies, Shanxi Medical University, Taiyuan City, 030000, Shanxi Province, China
| | - Qing Wang
- Faculty of Graduate Studies, Shanxi Medical University, Taiyuan City, 030000, Shanxi Province, China
| | - Hezhao Zhang
- Department of Gastroenterology, First Hospital of Shanxi Medical University, Jie Fang South Road No.85, Taiyuan City, 030000, Shanxi Province, China
| | - Jingwei Liu
- Faculty of Graduate Studies, Shanxi Medical University, Taiyuan City, 030000, Shanxi Province, China
| | - Jinnan Ren
- Faculty of Graduate Studies, Shanxi Medical University, Taiyuan City, 030000, Shanxi Province, China
| | - Jing Fan
- Department of Gastroenterology, Shanxi Provincial People's Hospital, Taiyuan City, 030000, Shanxi Province, China
| | - Jingwen Gong
- Faculty of Graduate Studies, Shanxi Medical University, Taiyuan City, 030000, Shanxi Province, China
| | - Yue Sui
- Faculty of Graduate Studies, Shanxi Medical University, Taiyuan City, 030000, Shanxi Province, China
| | - Xing Chen
- Department of Gastroenterology, First Hospital of Shanxi Medical University, Jie Fang South Road No.85, Taiyuan City, 030000, Shanxi Province, China.
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2
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Jensen JD, Loewen S, Berger J, Upshaw SJ, Christy KR, Lillie HM. Targeted communication and race: explicating perceived message relevance. Psychol Health 2022:1-18. [PMID: 36238974 DOI: 10.1080/08870446.2022.2132502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
Objectives: Targeting is a communication strategy in which a message is designed to address a particular group. It has been postulated that targeting increases message relevance; however, researchers are still explicating relevance and its impact on downline cognitive processes (e.g. message quality, cognitive cost). The current study addresses both gaps by evaluating the impact of targeted materials for White and African American audiences. Design: Adult women (N = 266) aged 18-74 (Mage = 47.12, SD = 1.40) were recruited to participate in a 2 (targeting: multiracial, African American) × 2 (race: White participants, African American participants) × 2 (topic: Hypertension, Environmental Breast Cancer) message experiment. Results: Across both topics, African American participants in the African American condition had reduced cognitive costs, increased message clarity, and increased message relevance. An indirect serial mediation model was supported wherein the relationship between targeting and behavioral intention was mediated by perceived relevance and perceived message quality. Conclusion: Targeting enhances perceived message relevance which, in turn, impacts behavioral intentions via perceived message quality. This model is consistent with the postulates of relevance theory and informs both intervention design and evaluation.
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Affiliation(s)
- Jakob D Jensen
- Department of Communication, University of Utah, Salt Lake City, UT, USA
| | - Sherrie Loewen
- College of Health, Chaffey College, Rancho Cucamonga, CA, USA
| | - Julia Berger
- Department of Communication, University of Utah, Salt Lake City, UT, USA
| | - Sean J Upshaw
- Moody School of Communication, The University of Texas at Austin, Austin, TX, USA
| | - Katheryn R Christy
- School of Journalism & Mass Communication, University of Wisconsin, Madison, WI, USA
| | - Helen M Lillie
- Department of Communication Studies, University of Iowa, Iowa City, IA, USA
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3
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Shah SC. Improving the Endoscopic Detection and Management of Gastric Intestinal Metaplasia Through Training: A Practical Guide. Gastroenterology 2022; 163:806-811. [PMID: 35931107 PMCID: PMC10027538 DOI: 10.1053/j.gastro.2022.07.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Shailja C Shah
- Gastroenterology Section, VA San Diego Healthcare System, La Jolla, California; Division of Gastroenterology, University of California, San Diego, La Jolla, California; Cancer Prevention and Control Program, UCSD Moores Cancer Center, La Jolla, California.
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Shah SC, Bonnet K, Schulte R, Peek RM, Schlundt D, Roumie CL. Helicobacter pylori Management Is Associated with Predominantly Negative Patient Experiences: Results from a Focused Qualitative Analysis. Dig Dis Sci 2022; 67:4387-4394. [PMID: 35034240 PMCID: PMC9287490 DOI: 10.1007/s10620-021-07320-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 11/08/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Helicobacter pylori eradication is associated with reduced gastric cancer and peptic ulcer disease incidence and mortality. Factors influencing patients' experiences surrounding H. pylori diagnosis and management are not well-described. Current patient perceptions can influence adherence to treatment, and also their anxieties related to this potentially carcinogenic condition. The objective of this study was to understand the patient experience surrounding H. pylori management and to qualitatively construct a contextual framework to inform and guide providers who manage patients with H. pylori infection. METHODS We conducted a qualitative analysis using a focus group and one-on-one telephone interviews. An iterative inductive/deductive approach was applied to recorded transcripts to identify and hierarchically order themes. Patient experience was defined according to major themes within a structured health behavior framework. RESULTS Theme saturation was achieved with thirteen participants (mean age 50.4 years; 62% female; 38% non-Hispanic white). Qualitative analysis yielded a total of 987 codes that resulted in five major themes related to the patient H. pylori experience: context of decision-making; health beliefs; barriers experienced; cues to action; and impact of new knowledge. These themes aligned with the Health Behavior Model framework. Participants were motivated to treat H. pylori. However, the experience was more often perceived negatively versus positively. The perceived patient-provider interaction contributed most prominently to the negative experience compared to other patient experiences, including treatment-related side effects. Internal cues, including symptoms and fear of cancer, modified participants' perceptions and motivation to accept treatment. CONCLUSIONS Patient experiences related to H. pylori management are predominantly negative. Increasing providers' awareness about patients' values, beliefs, anxieties, and expectations surrounding H. pylori diagnosis/treatment may improve provider-patient communication and, ideally, related outcomes.
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Affiliation(s)
- Shailja C Shah
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA.
- GI Section, Veterans Affairs San Diego Healthcare System,, 3350 La Jolla Village Drive 3rd Floor (Mail Code -111D), San Diego, CA, 92161, USA.
- Division of Gastroenterology, University of California, San Diego, San Diego, CA, USA.
| | - Kemberlee Bonnet
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Rebecca Schulte
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Richard M Peek
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA
| | - David Schlundt
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Christianne L Roumie
- Department of Veterans Affairs, Medical Service and Geriatric Research and Education Clinical Center (GRECC), Tennessee Valley Healthcare System, Nashville, TN, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville TN, USA
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van Schooten TS, Derks S, Jiménez-Martí E, Carneiro F, Figueiredo C, Ruiz E, Alsina M, Molero C, Garrido M, Riquelme A, Caballero C, Lezcano E, O'Connor JM, Esteso F, Farrés J, Mas JM, Lordick F, Vogt J, Cardone A, Girvalaki C, Cervantes A, Fleitas T. The LEGACy study: a European and Latin American consortium to identify risk factors and molecular phenotypes in gastric cancer to improve prevention strategies and personalized clinical decision making globally. BMC Cancer 2022; 22:646. [PMID: 35692051 PMCID: PMC9190072 DOI: 10.1186/s12885-022-09689-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/24/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Gastric Cancer (GC) is the fourth most deadly cancer worldwide. Enhanced understanding of its key epidemiological and molecular drivers is urgently needed to lower the incidence and improve outcomes. Furthermore, tumor biology in European (EU) and Latin American (LATAM) countries is understudied. The LEGACy study is a Horizon 2020 funded multi-institutional research approach to 1) detail the epidemiological features including risk factors of GC in current time and 2) develop cost-effective methods to identify and integrate biological biomarkers needed to guide diagnostic and therapeutic approaches with the aim of filling the knowledge gap on GC in these areas. METHODS This observational study has three parts that are conducted in parallel during 2019-2023 across recruiting centers from four EU and four LATAM countries: Part 1) A case-control study (800 cases and 800 controls) using questionnaires on candidate risk factors for GC, which will be correlated with clinical, demographic and epidemiological parameters. Part 2) A case-control tissue sampling study (400 cases and 400 controls) using proteome, genome, microbiome and immune analyses to characterize advanced (stage III and IV) GC. Patients in this part of the study will be followed over time to observe clinical outcomes. The first half of samples will be used as training cohort to identify the most relevant risk factors and biomarkers, which will be selected to propose cost-effective diagnostic and predictive methods that will be validated with the second half of samples. Part 3) An educational study, as part of our prevention strategy (subjects recruited from the general public) to test and disseminate knowledge on GC risk factors and symptoms by a questionnaire and informative video. Patients could be recruited for more than one of the three LEGACy studies. DISCUSSION The LEGACy study aims to generate novel, in-depth knowledge on the tumor biological characteristics through integrating epidemiological, multi-omics and clinical data from GC patients at an EU-LATAM partnership. During the study, cost-effective panels with potential use in clinical decision making will be developed and validated. TRIAL REGISTRATION ClinicalTrials.gov Identifiers: Part 1: NCT03957031 . Part 2: NCT04015466 . Part 3: NCT04019808 .
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Affiliation(s)
- Tessa Suzanne van Schooten
- Amsterdam UMC-location VUMC, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Oncode Institute, Utrecht, The Netherlands
| | - Sarah Derks
- Amsterdam UMC-location VUMC, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Oncode Institute, Utrecht, The Netherlands
| | - Elena Jiménez-Martí
- Instituto Investigación Sanitaria INCLIVA (INCLIVA), CIBERONC, Medical Oncology Department, Hospital Clínico Universitario de Valencia, Universitat de Valencia, Valencia, Spain
| | - Fatima Carneiro
- Institute of Pathology and Molecular Immunology of the University of Porto (IPATIMUP)/Institute of Research and Innovation in Health (i3S); Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ceu Figueiredo
- Institute of Pathology and Molecular Immunology of the University of Porto (IPATIMUP)/Institute of Research and Innovation in Health (i3S); Faculty of Medicine, University of Porto, Porto, Portugal
| | - Erika Ruiz
- Instituto Nacional de Cancerología (INCAN), Translational Medicine Laboratory & GI Cancer Department, Mexico City, Mexico
| | - Maria Alsina
- Valld'Hebron Institute of Oncology (VHIO), Medical Oncology Department, Barcelona, Spain
| | - Cristina Molero
- Valld'Hebron Institute of Oncology (VHIO), Medical Oncology Department, Barcelona, Spain
| | - Marcelo Garrido
- Pontificia Universidad Católica de Chile (PUC), Department of Hemato-Oncology, Santiago, Chile
| | - Arnoldo Riquelme
- Pontificia Universidad Católica de Chile (PUC), Department of Hemato-Oncology, Santiago, Chile
| | | | - Eva Lezcano
- Instituto de Previsión Social, Asunción, Paraguay
| | - Juan Manuel O'Connor
- Instituto Alexander Fleming (IAF), Medical Oncology Department, Buenos Aires, Argentina
| | - Federico Esteso
- Instituto Alexander Fleming (IAF), Medical Oncology Department, Buenos Aires, Argentina
| | | | | | - Florian Lordick
- Universitaet Leipzig (ULEI), Medical Oncology Department, Leipzig, Germany
| | - Jeannette Vogt
- Universitaet Leipzig (ULEI), Medical Oncology Department, Leipzig, Germany
| | | | | | - Andrés Cervantes
- Instituto Investigación Sanitaria INCLIVA (INCLIVA), CIBERONC, Medical Oncology Department, Hospital Clínico Universitario de Valencia, Universitat de Valencia, Valencia, Spain.
| | - Tania Fleitas
- Instituto Investigación Sanitaria INCLIVA (INCLIVA), CIBERONC, Medical Oncology Department, Hospital Clínico Universitario de Valencia, Universitat de Valencia, Valencia, Spain.
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Janati A, Kabiri N, Khodayari-zarnaq R, Khoshbaten M. Gastrointestinal cancer prevention policies: A qualitative systematic review and meta-synthesis. Int J Prev Med 2022; 13:8. [PMID: 35281982 PMCID: PMC8883678 DOI: 10.4103/ijpvm.ijpvm_419_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 01/21/2021] [Indexed: 11/17/2022] Open
Abstract
This qualitative systematic review was conducted to summarize the policies for prevention of common gastrointestinal cancers worldwide. This study was conducted using PubMed, Web of Science, SCOPUS, and ProQuest databases. Two independent reviewers assessed included studies for methodological quality and extracted data by using standardized tools from Joanna Briggs Institute (JBI). Primary study findings were read and reread to identify the strategies or policies used in the studies for prevention of gastrointestinal cancers. The extracted findings were categorized on the basis of their similarity in meaning. These categories were then subjected to a meta-synthesis. The final synthesized findings were graded according to the ConQual approach for establishing confidence in the output of qualitative research synthesis. From the nine included studies in this review, 39 findings were extracted and based on their relevance in meaning were aggregated into 12 categories. Four synthesized findings were developed from these categories. We used World Health Organization report on 2000 for synthesizing the findings. The four synthesized findings were “service provision”, “resource generation”, “financing”, and “stewardship”. In order to reach a comprehensive evidence informed policy package for the prevention of gastrointestinal cancers, there should be a great communication among the interventions conducted directly on patients, health system infrastructures, and resources.
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Canakis A, Pani E, Saumoy M, Shah SC. Decision model analyses of upper endoscopy for gastric cancer screening and preneoplasia surveillance: a systematic review. Therap Adv Gastroenterol 2020; 13:1756284820941662. [PMID: 32728390 PMCID: PMC7366398 DOI: 10.1177/1756284820941662] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/22/2020] [Indexed: 02/06/2023] Open
Abstract
AIMS Gastric cancer (GC) is the third leading cause of cancer death worldwide, but the burden of disease is not distributed evenly. GC screening routinely occurs in some high-incidence regions/countries and is generally cost-effective, which is attributed largely to the associated GC mortality reduction. In regions of low-intermediate incidence, less is known about the outcomes of GC screening and gastric precancer surveillance, including cost-effectiveness, since there are no comparative clinical studies. Decision analytic studies are informative in such instances where logistical limitations preclude "gold standard" study designs. We therefore aimed to conduct a systematic review of decision model analyses focused on endoscopic GC screening or precancer surveillance. METHODS We identified decision model analyses, including cost effectiveness and cost utility studies, of GC screening or preneoplasia surveillance. At minimum, articles were evaluated for: study country; analytic design; population and health states; time horizon; model assumptions; outcomes; threshold value(s) for "cost-effective" determination; and sensitivity analyses. Quality appraisal was performed using a modified Drummond's analytic scoring system. Data sources were PubMed, Web of Science, Embase, and the Cochrane Library. RESULTS We identified 17 studies (8 screening, 4 surveillance, and 5 screening and surveillance) that met full inclusion criteria. Endoscopic screening in countries of high GC incidence was cost-effective across all studies; targeted screening of high-risk populations within otherwise low-intermediate incidence countries was also generally cost-effective. Surveillance of gastric precancer, including atrophic gastritis or gastric intestinal metaplasia, was generally cost-effective. Most studies had high appraisal scores, with 4 (24%) studies achieving perfect scores on the Drummond scale. CONCLUSION Decision model analyses offer a unique mechanism with which to efficiently explore the cost benefit of various prevention and early detection strategies. Based on this comprehensive systematic review, upper endoscopy for GC screening and gastric precancer surveillance might be cost-effective depending on the population and protocol. Focused efforts are especially needed not only to define the optimal approach, but also to define the populations within otherwise low-intermediate regions/countries who might benefit most.
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Affiliation(s)
- Andrew Canakis
- Department of Medicine, Boston University
Medical Center, Boston, Massachusetts, USA
| | - Ethan Pani
- Department of Medicine, University of
Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Monica Saumoy
- Division of Gastroenterology and Hepatology,
University of Pennsylvania Perelman School of Medicine, Philadelphia, PA,
USA
| | - Shailja C. Shah
- Division of Gastroenterology, Hepatology, and
Nutrition, Vanderbilt University Medical Center, 2215 Garland Avenue,
Medical Research Building IV, Room 1030-C (mail), Nashville, TN 37232-0252,
USA
- Section of Gastroenterology, Veterans Affairs
Tennessee Valley Health System, Nashville, TN, USA
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In H, Solsky I, Castle PE, Schechter CB, Parides M, Friedmann P, Wylie-Rosett J, Kemeny MM, Rapkin BD. Utilizing Cultural and Ethnic Variables in Screening Models to Identify Individuals at High Risk for Gastric Cancer: A Pilot Study. Cancer Prev Res (Phila) 2020; 13:687-698. [PMID: 32409594 DOI: 10.1158/1940-6207.capr-19-0490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/26/2020] [Accepted: 04/23/2020] [Indexed: 11/16/2022]
Abstract
Identifying persons at high risk for gastric cancer is needed for targeted interventions for prevention and control in low-incidence regions. Combining ethnic/cultural factors with conventional gastric cancer risk factors may enhance identification of high-risk persons. Data from a prior case-control study (40 gastric cancer cases and 100 controls) were used. A "conventional model" using risk factors included in the Harvard Cancer Risk Index's gastric cancer module was compared with a "parsimonious model" created from the most predictive variables of the conventional model as well as ethnic/cultural and socioeconomic variables. Model probability cutoffs aimed to identify a cohort with at least 10 times the baseline risk using Bayes' Theorem applied to baseline U.S. gastric cancer incidence. The parsimonious model included age, U.S. generation, race, cultural food at ages 15-18 years, excessive salt, education, alcohol, and family history. This 11-item model enriched the baseline risk by 10-fold, at the 0.5 probability level cutoff, with an estimated sensitivity of 72% [95% confidence interval (CI), 64-80], specificity of 94% (95% CI, 90-97), and ability to identify a subcohort with gastric cancer prevalence of 128.5 per 100,000. The conventional model was only able to reach a risk level of 9.8 times baseline with a corresponding sensitivity of 31% (95% CI, 23-39) and specificity of 97% (95% CI, 94-99). Cultural and ethnic data may add important information to models for identifying U.S. individuals at high risk for gastric cancer, who then could be targeted for interventions to prevent and control gastric cancer. The findings of this pilot study remain to be validated in an external dataset.
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Affiliation(s)
- Haejin In
- Department of Surgery, Montefiore Medical Center, New York, New York. .,Department of Surgery, Albert Einstein College of Medicine, New York, New York.,Department of Epidemiology & Population Health, Albert Einstein College of Medicine, New York, New York
| | - Ian Solsky
- Department of Surgery, Montefiore Medical Center, New York, New York
| | - Philip E Castle
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, New York, New York
| | - Clyde B Schechter
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, New York, New York.,Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, New York
| | - Michael Parides
- Department of Surgery, Montefiore Medical Center, New York, New York
| | | | - Judith Wylie-Rosett
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, New York, New York
| | | | - Bruce D Rapkin
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, New York, New York
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Gastric Cancer in Young Adults: A Different Clinical Entity from Carcinogenesis to Prognosis. Gastroenterol Res Pract 2020; 2020:9512707. [PMID: 32190044 PMCID: PMC7071806 DOI: 10.1155/2020/9512707] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/13/2020] [Indexed: 02/07/2023] Open
Abstract
Approximately 5.0% of gastric cancer (GC) patients are diagnosed before the age of 40 and are not candidates for screening programs in most countries and regions. The incidence of gastric cancer in young adults (GCYA) has declined over time in most countries except in the United States. Genetic alterations, environmental factors, and lifestyle may predispose some young adults to GC. According to molecular classifications, the cancer of most GCYA patients belongs to the genomically stable or microsatellite stable/epithelial-mesenchymal transition subtype, with the common genetic aberrations being mutations in CDH1. What characterizes GCYA are a higher prevalence in females, more aggressive tumor behaviors, diagnosis at advanced stages, fewer comorbidities and being better treatment candidates, and a similar or better survival outcome when compared with older patients. Considering the greater loss of life-years in younger patients, lowering the incidence of GC and diagnosing at a relatively early stage are the two most effective ways to decrease GC mortality. To achieve these goals, the low awareness of GCYA among general people, policy-makers, clinicians, and researchers should be changed.
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In H, Langdon-Embry M, Gordon L, Schechter CB, Wylie-Rosett J, Castle PE, Margaret Kemeny M, Rapkin BD. Can a gastric cancer risk survey identify high-risk patients for endoscopic screening? A pilot study. J Surg Res 2018; 227:246-256. [PMID: 29622399 DOI: 10.1016/j.jss.2018.02.053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/22/2018] [Accepted: 02/27/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND A questionnaire that distinguishes how variability in gastric cancer prevalence is associated with ethnicity/birth country/immigration/cultural diet along with known risk factors may improve targeting populations for gastric cancer screening in the United States. METHODS Existing literature was used to identify the item pool. Cluster analysis, focus groups, and cognitive interviewing were used to reduce collinear items and refine the questionnaire. Logistic regression analysis was used to determine which items distinguished gastric cancer cases from the primary care and community controls. RESULTS The results of analysis of data from 40 cases and 100 controls (primary care = 47; community = 53) were used to reduce the 227 item pool to 12 items. After ranking these variables using model bootstrapping, a logistic regression model using the highest ranked eight variables was chosen as the final model. Older age, foreign nativity, daily consumption of cultural food at ages 15-18, less than high-school education, and greater acculturation were significantly associated with being a gastric cancer case compared with the controls. CONCLUSIONS An eight-item survey that addresses gastric cancer risk factors, ethnicity, cultural habits, and immigration patterns has potential to identify high-risk persons from multicultural areas within the US, who might benefit from endoscopic screening for gastric cancer.
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Affiliation(s)
- Haejin In
- Montefiore Medical Center/Albert Einstein College of Medicine, Department of Surgery, Bronx, New York; Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, New York.
| | - Marisa Langdon-Embry
- Montefiore Medical Center/Albert Einstein College of Medicine, Department of Surgery, Bronx, New York
| | - Lauren Gordon
- Montefiore Medical Center/Albert Einstein College of Medicine, Department of Surgery, Bronx, New York
| | - Clyde B Schechter
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, New York; Albert Einstein College of Medicine, Department of Family and Social Medicine, Bronx, New York
| | - Judith Wylie-Rosett
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, New York
| | - Philip E Castle
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, New York
| | | | - Bruce D Rapkin
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, New York
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