Satisfaction in population-based cancer screening in a Chinese rural high-risk population: the Yangzhong early diagnosis and treatment of upper gastrointestinal cancer.

BACKGROUND: Screening for upper gastrointestinal cancer (UGC) effectively reduces morbidity and mortality in gastric and esophageal cancers. It is considered one of the effective measures for cancer control in China, but studies on its functional quality are lacking. Our study assessed the quality of screening service funded by Upper Gastrointestinal Cancer Early diagnosis and treatment (UGCEDAT) and its correlation in Yangzhong People's hospital, China. METHODS: A cross-sectional study was conducted among 516 screening users at a screening centre in Yanghzong People's hospital from April to July 2021. The service quality questionnaire (SERVQUAL) based on the service quality gap (SQG) model was adopted. We calculated the mean scores of perceptions and expectations and their gap. To determine the association between overall SQG and related features of participants, we used a multivariate logistic regression. RESULTS: The average scores of screening service users' perceptions and expectations were 4.05 and 4.55, respectively. The SQG of five dimensions (tangibles, reliability, responsiveness, assurance and empathy) were negative, and the overall SQG was -0.51. The responsiveness dimension had the largest gap, and tangibles had the smallest gap. Occupation status (AOR: 0.57; CI: 0.37-0.89), health self-assessment (AOR: 4.97; CI: 1.35-18.23), endoscopy experience (AOR: 0.55; CI: 0.38-0.81), distance from screening hospital (AOR: 1.85; CI: 1.25-2.73) and frequency of visit (AOR: 1.65; CI: 1.10-2.46) were associated with the overall SQG. CONCLUSIONS: We observed a negative gap between perceptions and expectations of the function quality of screening service, implying a high dissatisfaction across different dimensions. Service providers should take adequate measures to bridge the dimension with the largest quality gap. Meanwhile, attention should be paid to identifying the influencing factors of the overall SQG and the characteristics of dimensional expectations and perceptions to improve the effectiveness of the screening program.

Prevalence and coprevalence of modifiable risk factors for upper digestive tract cancer among residents aged 40-69 years in Yangzhong city, China: a cross-sectional study.

OBJECTIVES: To describe the prevalence of modifiable risk factors for upper digestive tract cancer (UDTC) and its coprevalence, and investigate relevant influencing factors of modifiable UDTC risk factors coprevalence among residents aged 40-69 years in Yangzhong city, China. DESIGN: Cross-sectional study. PARTICIPANTS: A total of 21 175 participants aged 40-69 years were enrolled in the study. 1962 subjects were excluded due to missing age, marital status or some other selected information. Eventually, 19 213 participants were available for the present analysis. MAIN OUTCOMES MEASURES: Prevalence and coprevalence of eight modifiable UDTC risk factors (overweight or obesity, current smoking, excessive alcohol consumption, insufficient vegetables intake, insufficient fruit intake and the consumption of pickled, fried and hot food) were analysed. RESULTS: The prevalence of overweight/obesity, current smoking, excessive alcohol consumption, insufficient vegetables intake, insufficient fruit intake and the consumption of pickled, fried and hot food in this study was 45.3%, 24.1%, 16.2%, 66.1%, 94.5%, 68.1%, 36.0% and 88.4%, respectively. Nearly all (99.9%) participants showed one or more UDTC risk factors, 98.6% of the participants showed at least two risk factors, 92.2% of the participants had at least three risk factors and 69.7% of the participants had four or more risk factors. Multivariate logistic regression analysis revealed that men, younger age, single, higher education, higher annual family income and smaller household size were more likely to present modifiable UDTC risk factors coprevalence. CONCLUSIONS: The prevalence and coprevalence of modifiable UDTC risk factors are high among participants in Yangzhong city. Extra attention must be paid to these groups who are susceptible to risk factors coprevalence during screening progress. Relative departments also need to make significant public health programmes that aim to decrease modifiable UDTC risk factors coprevalence among residents aged 40-69 years from high-risk areas of UDTC.

[TH1/TH2 type cytokine expression and DNA aberrant methylation analysis in peripheral blood of coke oven workers].

OBJECTIVE: To understand the exposure levels of polycyclic aromatic hydrocarbons(PAHs) and the expression of interleukin-2(IL-2), interferon-γ(IFN-γ), interleukin-4(IL-4), interleukin-10(IL-10) in peripheral blood of coke oven workers exposed to coke oven emissions(COEs). The other purpose of this study was to understand the performance of IFN-γ and IL-10 epigenetic mechanisms in COEs exposure damage. METHODS: The 85 workers exposed to COEs in a coking plant were randomly selected as the exposure group. The 47 workers who were exposed to non-COEs in the coking plant were used as the control group. The morning urine of the exposure group and the control group were subjected to detection of 1-OHPyr levels with alkaline hydrolysis High-performance liquid chromatography fluorescence, urine creatinine correction. The peripheral venous blood were subjected to detection of the expression of IL-2, IFN-γ, IL-4 and IL-10 with enzyme-linked immunosorbent assay. And methylation levels of IFN-γ and IL-10 were analyzed by time of flight mass spectrometry. RESULTS: The urine 1-hyroxy-pyrene(1-OHPyr) content of coke oven workers was higher than that of the control group(F=12. 446, P<0. 05). The urine 1-OHPyr content of the furnace side and the furnace top were higher than the control group, and the differences were statistically significant. Compared with the control group, serum IL-2 content of coke oven workers decreased(F=14. 774, P<0. 05), and serum IFN-γ content of coke oven workers decreased(F=46. 379, P<0. 05), the serum IL-4 content of coke oven workers increased(F=17. 426, P<0. 05), the serum IL-10 content of coke oven workers increased(F=33. 515, P<0. 05), and the TH1/TH2 ratio of coke oven workers decreased(F=21. 677, P<0. 05). In the exposed group, the level of IFN-γ in the top of the furnace was higher than that in the bottom of the furnace. The difference was statistically significant. The level of IL-10 in the top and bottom of the furnace was lower than that in the furnace. The difference was statistically significant. The IL-10 CpG-11, CpG-15 and mean methylation rates in the exposed group were lower than those in the control group, and the differences were statistically significant. The methylation rate of IFN-γ CpG-5 in the exposed group was higher than that in the control group, and the difference was statistically significant. The urine 1-OHPyr content of coke oven workers was negatively correlated with TH1/TH2 ratio and IFN-γ expression level, and positively correlated with IL-4 and IL-10 levels. The IL-10 CpG-11, CpG-15 methylation rate decreased with increasing urine 1-OHPyr concentration. CONCLUSION: The side and top of the furnace worker exposed to COEs were the key targets for occupational health. The exposure of coke oven workers to COEs affected the expression of immunoregulatory cytokines. The exposure of COEs caused the change of IL-10 methylation rate.