How do international gastric cancer prevention guidelines influence clinical practice globally?

Evita Gasenko, Marcis Leja, Inese Polaka, Alinta Hegmane, Raul Murillo, Dmitry Bordin, Alexander Link, Minna Kulju, Pawel Mochalski, Gidi Shani, Peter Malfertheiner, Rolando Herrero, Hossam Haick

    Research output: Contribution to journalArticleScientificpeer-review

    3 Citations (Scopus)


    Clinical guidelines recommend particular approaches, including 'screen-and-treat' strategy for Helicobacter pylori, to prevent gastric cancer. However, little of this is implemented in clinical practice. The aim of the study was to identify barriers to implementation of international guidelines. A web-based questionnaire distributed globally to specialists in the field. Altogether 886 responses from 75 countries were received. Of the responders, 570 (64%) were men of mean age 47 years. There were 606 gastroenterologists and 65 epidemiologists among the responders. Altogether, 79.8% of the responders disagreed that the burden of gastric cancer is a diminishing problem. 'Screen-and-treat' strategy for H. pylori in the responder's country was considered appropriate by 44.4%, inappropriate by 24.3%, with 31.3% being uncertain. Population-based screening for gastric cancer was considered appropriate in the respective home-country by 62.2%, in other areas - but not the home country - by 27.6%, and inappropriate by 10.2%. As a screening tool, upper endoscopy was acceptable by 35.6%, upper X-ray series by 55.3%, pepsinogens by 26.2% and breath-tests by 23.4%; accuracy, cost-effectiveness and feasibility among the tests varied widely. The attitude towards H. pylori vaccination was that 4.6% of the responders were eager to start vaccination immediately, 55.9% were supporting vaccination but considered that more data are required 12% were negative, and 27.6% did not have an opinion. In general, the attitude of the specialists was in line with guidelines, but was not always translated into clinical practice, particularly in the case of 'screen-and-treat' strategy.

    Original languageEnglish
    Pages (from-to)400-407
    Number of pages8
    JournalEuropean journal of cancer prevention
    Issue number5
    Publication statusPublished - Sept 2020
    MoE publication typeA1 Journal article-refereed


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