Clin Endosc.  2023 Jul;56(4):460-469. 10.5946/ce.2022.167.

Exploring quality indicators for the detection of Helicobacter pylori-naïve gastric cancer: a cross-sectional nationwide survey

• Ishibashi F
• Hirasawa T
• Ueyama H
• Minato Y
• Suzuki S

• KMID: 2544569
• DOI: http://doi.org/10.5946/ce.2022.167

Abstract

Background/Aims
Diagnosis of Helicobacter pylori-naïve gastric cancer (HPNGC) is becoming increasingly important. This study aimed to explore the quality indicators for HPNGC detection.
Methods
We conducted a cross-sectional, nationwide, web-based survey of gastrointestinal endoscopists in Japan. In addition to questions about the number of HPNGC cases detected in a year and basic information, the questionnaire also consisted of 28 questions: (1) 18 about HPNGC awareness, (2) six about diagnostic proactiveness, and (3) four about interest in HPNGC.
Results
Valid responses were obtained from 712 endoscopists. The Japan Gastroenterological Endoscopy Society-certified endoscopists had a significantly higher HPNGC detection rate than the nonspecialists (0.42% vs. 0.32%, respectively; p=0.008). The results of the multiple regression analysis showed that Japan Gastroenterological Endoscopy Society certification and high awareness and interest scores were independent predictors of the HPNGC detection rate (p=0.012, p<0.001, p=0.024, respectively). Principal component analysis showed that the endoscopists who attended conferences for collecting information on HPNGC had a higher level of awareness.
Conclusions
To improve the detection of HPNGC, it is necessary to increase the awareness of the disease. It is hoped that relevant societies will play an important role in endoscopists’ education.

Keyword

Detection; Gastric cancer; Quality indicator

Figure

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  Fig. 1. Relationship between the endoscopist background and the Helicobacter pylori-naïve gastric cancer (HPNGC) detection rate. (A) Relationship with experience in endoscopy (years). (B) Relationship with the size of the endoscopist's facility. (C) Relationship with the location (prefecture) of the facility where the endoscopist is affiliated. (D) Relationship with the endoscopist's area of expertise. (E) Relationship with whether the endoscopist obtained the Japan Gastroenterological Endoscopy Society certification as an endoscopist.

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  Fig. 2. Association of endoscopist background with awareness, proactiveness, and interest scores. (A) Relationship with experience in endoscopy (years). (B) Relationship with the size of the endoscopist's facility. (C) Relationship with the location (prefecture) of the facility where the endoscopist is affiliated. (D) Relationship with the endoscopist’s area of expertise. (E) Relationship with whether the endoscopist obtained the Japan Gastroenterological Endoscopy Society certification.

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  Fig. 3. Principal component analyses (PCAs) of endoscopists’ backgrounds, and awareness, proactiveness and interest scores. Each dot indicates the position of the endoscopist on the PCA map. The lighter the blue color of the dots, the higher the score. (A) PCA map classified by scores related to gastric adenocarcinoma of the fundic-gland type (GA-FG) among the components of the awareness score. (B) PCA map classified by scores related to raspberry-like tumors among the components of the awareness score. (C) PCA map classified by scores related to pure signet ring cell carcinoma (PSRCC) among the components of the awareness score. (D) PCA map classified by scores related to attendance at scientific meetings among the components of the interest score. (E) PCA map classified by the scores related to web-based information collection among the components of the interest score. (F) PCA map legend. The size and direction of the black arrows indicate the contribution of each factor.

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