Financial Incentives and Motivational Intervention to Improve Gastric Cancer Screening in China

Gastric cancer (GC) remains a significant global health challenge, with high mortality rates, particularly in low- and middle-income country, like China. Early detection through screening is crucial for improving prognosis and reducing mortality. However, uptake of GC screening remains suboptimal, highlighting the need for effective interventions to promote screening participation.

This study employs an experimental design to evaluate the effectiveness of two interventions, financial incentives and motivational interventions, in promoting GC screening uptake at the individual level. A large sample size will be recruited from high GC-burden provinces in China, and participants will be randomly assigned to intervention and control groups. Statistical analyses, including Propensity Score Matching and Interrupted Time Series Analysis, will be utilized to assess the impact of interventions on screening uptake and adherence.

Findings from this study will be disseminated through peer-reviewed publications, conference presentations, and engagement with stakeholders to inform evidence-based strategies for improving GC screening and reducing GC-related morbidity and mortality.

Inclusion criteria

• Provision of informed consent by patients;
• Identification as "high risk" (≥5 scores) by Gastric Cancer Risk Scoring System (GC-RSS).

Exclusion criteria

• History of previous gastric cancer screening, including endoscopy and serum biomarker examination (pepsinogen, G-17, and MG7-Ag);
• Diagnosis of cancer or presence of precancerous lesions or conditions;
• Having family members who have already participated in this study;
• Diagnosis of severe depression or psychiatric disorder;
• Presence of other medical conditions that preclude receipt of endoscopy services.