Knowledge, beliefs, perceived barriers, and previous upper gastrointestinal endoscopy use regarding Helicobacter pylori and gastric cancer prevention among community residents: a cross-sectional study.

Authors

Huiying An, Xue Wang, Yan Chen, Lei Lei

Published in

Frontiers in public health. Volume 14. Pages 1912334. Epub Aug 14, 2026.

Abstract

Low adherence to primary and secondary prevention strategies for gastric cancer remains a major public health challenge. Understanding knowledge, beliefs, perceived barriers, and previous upper gastrointestinal endoscopy (UGE) use may help identify modifiable targets for prevention programs.
This study aimed to describe knowledge, beliefs, perceived barriers, and previous UGE use related to Helicobacter pylori infection and gastric cancer prevention among community residents in Henan Province, China, and to examine their associations.
A descriptive cross-sectional knowledge-attitude-practice survey was conducted among 1,911 community residents in Henan Province, China. Multivariable logistic regression was used to estimate adjusted odds ratios for previous UGE use. Bayesian path analysis was performed to explore indirect associations among knowledge, beliefs, perceived barriers, and previous UGE use. All results were interpreted as associations rather than causal effects.
Overall, 25.1% (480/1,911) of participants reported previous UGE use, and 15.3% reported a history of H. pylori infection. Previous UGE use was more common among participants with self-reported H. pylori infection (adjusted odds ratio [aOR] 2.29, 95% CI 1.70-3.08), a first-degree family history of gastric cancer (aOR 4.65, 95% CI 3.14-6.89), and gastrointestinal symptoms (aOR 1.67, 95% CI 1.32-2.10). Higher belief scores were associated with lower odds of previous UGE use (aOR 0.29, 95% CI 0.16-0.51). In Bayesian path analysis, knowledge was positively associated with beliefs (β = 0.502, p < 0.001) and previous UGE use (β = 0.126, p < 0.001), whereas perceived barriers were negatively associated with previous UGE use (β = -0.220).
Previous UGE use remained suboptimal despite generally favorable awareness and beliefs. These findings suggest an important gap between cognitive readiness and preventive action. Public health strategies should combine targeted health education with barrier reduction, risk-based referral, physician recommendation, and integration of H. pylori screen and treat strategies.

PMID:
42666250
Bibliographic data and abstract were imported from PubMed on 29 Aug 2026.

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