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Knowledge Gaps among Physicians Caring for Multiethnic Populations at Increased Gastric Cancer Risk
Shailja C Shah1, Steven H Itzkowitz1, Lina Jandorf2
1The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Background/Aims:
Although gastric cancer (GC) prevalence in the United States overall is low, there is significantly elevated risk in certain racial/ethnic groups. Providers caring for high-risk populations may not be fully aware of GC risk factors and may underestimate the potential for selective screening. Our aim was to identify knowledge gaps among healthcare providers with respect to GC.
Methods:
An Internet-based survey was distributed to primary care providers (PCPs) and gastroenterologists in New York City, which included questions regarding provider demographics, practice environment, GC risk factors, Helicobacter pylori, and screening practices. Three case vignettes were used to assess clinical management.
Results:
Of 151 included providers (111 PCPs, 40 gastroenterologists), most reported caring for a racially/ethnically diverse population and 58% recommended GC screening for select populations. Although ＞85% recommended against testing patients from regions where H. pylori, a known carcinogen, is endemic, ＜50% were able to correctly identify non-Asian endemic regions. Minorities of respondents correctly identified Hispanic/Latino (29%), Black (22%), and Eastern European/Russian (19.7%) as additional higher-risk races/ethnicities. Vignette-based questions highlighted variability in the management of potentially higher-risk patients.
Conclusions:
Despite caring for multiracial/ethnic populations, providers demonstrated deficiencies in identifying and managing patients with elevated GC risk. Focused educational efforts should be considered to address these deficiencies.