P2037 - A Community-Based Screening Survey for Gastric Cancer in High-Risk Populations

Effie M. Mathew, BS¹, Muyi Li, MD¹, Corey O'Brien, MD², Alex Schlachterman, MD^1
1Thomas Jefferson University Hospital, Philadelphia, PA; ²Thomas Jefferson University Hospital, Philadephia, PA

Introduction: Screening guidelines for gastric cancer are implemented in countries with high prevalence of gastric cancers. Despite low prevalence of gastric cancer in the U.S., higher rates of gastric cancer are noted in certain high-risk populations (i.e. adult Asian, Black, and Hispanic populations). Primary care physicians (PCPs) play a crucial role in detection of gastric cancer, yet screening guidelines for high-risk groups do not exist in the U.S. This study aims to obtain an understanding of how PCPs diagnose and treat gastric cancer in high-risk populations.

Methods: This is a prospective study in which surveys were sent to PCPs caring for predominantly Asian, Black, and/or Hispanic communities in Philadelphia. 45 surveys were sent and 22 (49%) were completed. The primary outcome was survey results regarding the screening, diagnosis, and treatment of gastric cancer practices in high-risk patient populations in PCPs.

Results: Out of 22 responses, 65% of PCPs completed training in the U.S. (Table 1). 35% had patient panels with >60% Black patients, while 23% had patient panels with >60% Asian patients. 59% of PCPs considered patients to be high-risk for gastric cancer when >50 years of age and 9% did not view age as a risk factor. 100% of surveyed PCPs viewed family history of gastric cancer as a risk factor; other reported risk factors were history of smoking (95.4%) and history of H. pylori infection (85%) (Figure 1). 51% of PCPs screen for gastric cancer by esophagogastroduodenoscopy (EGD) in symptomatic patients, 32% screen by EGD for high-risk patients regardless of symptoms, and 32% believe that no screening is required. 40% of respondents indicated that they screen for gastric cancer in the 50-59 age range. With regards to treatment, 64% of PCPs refer patients to gastroenterology for endoscopic intervention, while 32% refer to general surgery for surgical resection.

Discussion: PCP perceptions on diagnosis and management of gastric cancer vary. Age at which patients are deemed high-risk varied, but almost all PCPs regarded family history, smoking, and history of H. pylori infection as significant risk factors. There was notable variation in specialist referrals and interventions for management. These findings demonstrate the lack of guidance on gastric cancer screening for PCPs. Further studies are needed to establish guidelines for gastric cancer screening in high-risk populations in the U.S.


Figure: Figure 1: Respondents’ perceptions of risk factors for gastric cancer. n=21

Male, n (%)	15 (65%)
Female, n (%)	8 (35%)
Medical School/Residency Training
U.S.	15 (65%)
International	3 (13%)
Both	5 (22%)
Primary Care Patient Panels with >60% of...
Asian	5 (23%)
Black	8 (35%)
Hispanic	0 (0%)
Panels with >80% of patients born outside of the U.S.	4 (18%)

Table: Table 1: Baseline Characteristics of Respondents, n=22


Disclosures:
Effie Mathew indicated no relevant financial relationships.
Muyi Li indicated no relevant financial relationships.
Corey O''Brien indicated no relevant financial relationships.
Alex Schlachterman indicated no relevant financial relationships.


Effie M. Mathew, BS¹, Muyi Li, MD¹, Corey O'Brien, MD², Alex Schlachterman, MD¹. P2037 - A Community-Based Screening Survey for Gastric Cancer in High-Risk Populations, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.