Knowledge and Practice Gaps in Gastric Cancer Prevention Among Physicians in Azerbaijan: Results of the TOGAS National Survey

Vollständiger Abstract

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Background: Despite continuous advances in gastric cancer prevention, delayed recognition of premalignant gastric lesions and inconsistent implementation of evidence-based recommendations remain major barriers to reducing gastric cancer incidence and mortality. International guidelines emphasize Helicobacter pylori eradication, standardized biopsy protocols, OLGA/OLGIM risk stratification, and risk-adapted endoscopic surveillance. However, little is known regarding physicians’ awareness and adherence to these recommendations in Azerbaijan.Aim: To evaluate physicians’ knowledge and clinical practice regarding gastric cancer prevention and to identify specialty-related differences in the diagnosis, biopsy strategy, surveillance, and management of gastric precancerous conditions.Methods: A nationwide cross-sectional survey was conducted using the standardized TOGAS questionnaire. Among 967 completed questionnaires, 692 physicians representing four major specialties were included in the comparative analysis: general practitioners (n=372), family physicians (n=113), pediatricians (n=114), and gastroenterologists (n=93). The questionnaire evaluated knowledge of Helicobacter pylori infection, gastric precancerous lesions, diagnostic approaches to atrophic gastritis, biopsy practices, surveillance strategies, OLGA/OLGIM staging systems, and gastric cancer prevention. Categorical variables were compared using Pearson’s χ² test, while multivariable logistic regression adjusted for age and sex was performed to identify independent predictors of appropriate knowledge. Statistical significance was defined as p