Effectiveness of one-time endoscopic screening programme in prevention of upper gastrointestinal cancer in China: a multicentre population-based cohort study

ObjectivesTo estimate the effectiveness of endoscopic screening programme in reducing incidence and mortality of upper gastrointestinal cancer in high risks areas of China.DesignThis multicentre population-based cohort study was conducted in six areas in China from 2005 to 2015. All permanent residents aged 40 to 69 years were identified as target subjects. We refer to those who were invited for screening collectively as the invited group. Of these, we classify those who were invited and undertook endoscopic screening as the screened group and those who were invited but did not accept screening as the non-screened group. Target subjects who were not invited to the screening were assigned to the control group. The effectiveness of the endoscopic screening and screening programme were evaluated by comparing reductions in incidence and mortality from upper gastrointestinal cancer in the screened and invited group with control group.ResultsOur cohort analysis included 637 500 people: 299 483 in the control group and 338 017 in the invited to screening group, 113 340 (33.53%) of whom were screened eventually. Compared with subjects in the control group, upper gastrointestinal cancer incidence and mortality decreased by 23% (relative risk (RR)=0.77, 95% CI 0.74 to 0.81) and 57% (RR=0.43, 95% CI 0.40 to 0.47) in the screened group, respectively, and by 14% (RR=0.86, 95% CI 0.84 to 0.89) and 31% (RR=0.69, 95% CI 0.66 to 0.72) in the invited group, respectively.ConclusionAmong individuals aged 40 to 69 years in high risk areas of upper gastrointestinal cancer, one-time endoscopic screening programme was associated with a significant decrease in upper gastrointestinal cancer incidence and mortality.

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164 EFFECTIVENESS OF ONE-TIME ENDOSCOPIC SCREENING PROGRAM IN PREVENTION OF ESOPHAGEAL CANCER IN CHINA: A MULTI-CENTER POPULATION-BASED COHORT STUDY

Diseases of the Esophagus ◽

10.1093/dote/doaa087.31 ◽

2020 ◽

Vol 33 (Supplement_1) ◽

Author(s):

R Chen ◽

Y Liu ◽

G Song ◽

B Li ◽

D Zhao ◽

...

Keyword(s):

Esophageal Cancer ◽

Cohort Study ◽

High Risk ◽

Cancer Incidence ◽

Screening Program ◽

Population Based ◽

Control Group ◽

Endoscopic Screening ◽

Incidence And Mortality ◽

Risk Areas

Abstract Esophageal cancer is one of the most common cancers worldwide and half of all new cases occurred in China. Population-based endoscopic screening has been carried out in some high-risk areas in China since 2005, but previous evidence was based predominately on small-sample, single-center studies. We undertook a population-based, multi-center cohort study to estimate the effectiveness of endoscopic screening program in reducing the incidence and mortality of esophageal in high risks areas in China. Methods This study was conducted in six areas in China from 2005 to 2015. All permanent residents aged 40–69 yeas were identified as target subjects. We defined those who were invited and undertook endoscopic screening as the screened group, and those who refused screening as the non-screened group. The target subjects who were not invited to screening was assigned to the control group. The effectiveness of endoscopic screening and screening program were evaluated by comparing the reductions in the incidence and mortality from esophageal cancer in those screened or those invited to screening with reductions in the control group, respectively. Results Our cohort analysis included 637 500 people: 299 483 in the control group and 338 017 in the invited to screening group, 113 340 (33.53%) of whom were screened eventually. Compared with subjects in the control group, esophageal cancer incidence and mortality were reduced by 26% (relative risk(RR) 0.74, 95% confidence interval(CI), 0.69–0.79) and 60% (0.40, 0.36–0.45) respectively in those screened, and they were reduced by 15% (0.85, 0.82–0.89) and 33% (0.67, 0.63–0.71) respectively in those invited to screening. Conclusion Among individuals aged 40–69 years in high risk areas of esophageal cancer, one-time endoscopic screening program was associated with a significant decrease in esophageal cancer incidence and mortality.

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