{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:04:06Z","timestamp":1785301446649,"version":"3.55.0"},"reference-count":76,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Objective<\/jats:title>\n To estimate the pooled uptake of upper gastrointestinal endoscopic screening uptake and to identify factors associated with screening uptake among populations eligible for upper gastrointestinal endoscopic screening.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A systematic review and meta-analysis was conducted to identify studies reporting the uptake of upper gastrointestinal endoscopic screening and factors associated with screening participation. The pooled uptake was calculated using the random-effects model. For influencing factors, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. Heterogeneity was assessed using Cochran\u2019s Q test and the I\n 2<\/jats:sup>\n statistic. Subgroup analyses, meta-regression, leave-one-out sensitivity analysis, and publication bias assessment were performed to evaluate the robustness of the findings.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 48 studies involving 119,913,685 participants were included in the meta-analysis of screening uptake. The pooled uptake of upper gastrointestinal endoscopic screening was 38% (95% CI: 28\u201348%), with substantial heterogeneity. Subgroup analyses showed that screening uptake differed significantly by country (\n p<\/jats:italic>\n =\u202f0.047) and sample size (\n p<\/jats:italic>\n =\u202f0.001). Meta-regression indicated that publication year and sample size were not significant moderators of screening uptake (all\n p<\/jats:italic>\n \u202f&gt;\u202f0.05). Sensitivity analysis demonstrated that the pooled estimate remained stable after sequential omission of each study, and Egger\u2019s test did not indicate significant publication bias (\n p<\/jats:italic>\n =\u202f0.817). Among the 26 identified factors, 10 were included in the meta-analysis, and the remaining factors were summarized descriptively. The pooled results showed that female sex (OR\u202f=\u202f1.16, 95% CI: 1.07\u20131.27), higher education (OR\u202f=\u202f1.53, 95% CI: 1.35\u20131.74), occupational exposure to hazards (OR\u202f=\u202f1.15, 95% CI: 1.08\u20131.23), drinking shallow water (OR\u202f=\u202f1.32, 95% CI: 1.28\u20131.37), drinking deep well water (OR\u202f=\u202f1.22, 95% CI: 1.05\u20131.40), a history of upper gastrointestinal diseases (OR\u202f=\u202f1.94, 95% CI: 1.72\u20132.20), a family history of upper gastrointestinal cancer (OR\u202f=\u202f1.50, 95% CI: 1.29\u20131.74), and a family history of cancer (OR\u202f=\u202f1.57, 95% CI: 1.27\u20131.93) were associated with higher endoscopic screening uptake. In contrast, regular physical exercise (OR\u202f=\u202f0.89, 95% CI: 0.81\u20130.97) and current smoking (OR\u202f=\u202f0.86, 95% CI: 0.75\u20130.99) were associated with lower screening uptake.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The uptake of upper gastrointestinal endoscopic screening remains suboptimal among screening-eligible populations. Screening participation appears to be influenced by socioeconomic factors, lifestyle factors, disease-related factors, cognitive factors, healthcare-related factors. These findings may inform targeted interventions to improve screening uptake and optimize the implementation of upper gastrointestinal cancer screening programs.<\/jats:p>\n <\/jats:sec>\n \n Systematic review registration<\/jats:title>\n \n https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261279918<\/jats:ext-link>\n , identifier CRD420261279918.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1869526","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:48:54Z","timestamp":1785300534000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Upper gastrointestinal endoscopic screening uptake and associated factors in East Asia: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Yanjie","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU)","place":["Hangzhou, Zhejiang, China"]},{"name":"School of Nursing, Zhejiang University School of Medicine, Zhejiang University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"He","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU)","place":["Hangzhou, Zhejiang, China"]},{"name":"School of Nursing, Zhejiang University School of Medicine, Zhejiang University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU)","place":["Hangzhou, Zhejiang, China"]},{"name":"School of Nursing, Zhejiang University School of Medicine, Zhejiang University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhao","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU)","place":["Hangzhou, Zhejiang, China"]},{"name":"School of Nursing, Zhejiang University School of Medicine, Zhejiang University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanya","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU)","place":["Hangzhou, Zhejiang, China"]},{"name":"School of Nursing, Zhejiang University School of Medicine, Zhejiang University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunyu","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU)","place":["Hangzhou, Zhejiang, China"]},{"name":"School of Nursing, Zhejiang University School of Medicine, Zhejiang University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiling","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU)","place":["Hangzhou, Zhejiang, China"]},{"name":"School of Nursing, Zhejiang University School of Medicine, Zhejiang University","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuqin","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU)","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1016\/j.jncc.2026.02.005","article-title":"Upper gastrointestinal cancers global burden profile, trends, contributors, and attributable change in life expectancy from 1990 to 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