Introduction

Screening for early oesophageal adenocarcinoma (OAC) has the potential to reduce OAC-related mortality and morbidity. However, it is unknown which screening method and/or eligibility criteria the target population would find acceptable for a potential future screening program.

Aims & Methods

In this ongoing online population-based survey, we aim to identify Dutch individuals’ perceived barriers and facilitators to the uptake of OAC screening and their preferences regarding screening method and organization. We aim to include 2088 Dutch adults aged 45-75 years, who will be randomly assigned to three screening test scenarios (i.e., transnasal endoscopy, ingestible cell-collection device, or breath analysis). The primary outcome is intended participation. Secondary outcomes include anticipated discomfort, acceptability of test performance and eligibility criteria (on a Likert scale: 1 = not acceptable, 7 = extremely acceptable), and preferences regarding invitation, counselling, and diagnostic follow-up. Enrolment will end in June 2023.

Results

As per 12 April, 1653 participants have been included (49% male, 96% white, 22% with upper endoscopy experience). Preliminary analyses show that intended uptake of screening was highest in the breath analysis scenario (97%), followed by ingestible cell-collection devices (76%), and transnasal endoscopy (68%) (p<0.001). Having symptoms of gastro-oesophageal reflux disease (GORD) and having a high perceived risk of OAC are both associated with a positive intention to participate in screening. High anticipated discomfort and having negative beliefs about cancer screening are associated with negative intent. Across all test scenarios, both age and GORD were acceptable eligibility criteria to most participants (mean scores of 5.4 [±1.5] and 5.2 [±1.7]). Inviting only men was less acceptable to women (3.9 [±2.0]) than to men (5.2 [± 1.9]). Using a risk algorithm was generally accepted (5.1 [±1.6]), and most individuals were willing to provide personal information (e.g., on smoking: 6.3 [±1.1], skin colour: 6.2 [±1.2], family history: 6.1 [±1.2], waist circumference: 5.9 [±1.4], or access to medical file: 5.7 [±1.5]), and a blood sample (6.1 [±1.2]). The majority (61%) preferred to be invited by a public health organization and 34% of the participants preferred to discuss their decision to participate in screening with a health care professional.

Conclusion

These preliminary results suggest that Dutch individuals generally intend to participate in OAC screening, with a preference for the breath analysis test/non-invasive screening methods over cell-collection devices and transnasal endoscopy. Determining screening eligibility based on age, GORD, or personal information, would be acceptable to most individuals. Male gender appears to be the least acceptable eligibility criterion.

Disclosure

JS, LR, FM, MB, and YP have no conflicts of interest or financial ties related to this work to disclose. PS is receiving unrestricted research grants from Pentax (Japan), Norgine (UK), Motus GI (USA), MicroTech (China) and The eNose Company (Netherlands) and is in the advisory board of Motus GI (US) and Boston Scientific (US).