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

Affiliation

Chen R(#)(1), Liu Y(#)(2), Song G(#)(3), Li B(#)(4), Zhao D(#)(5), Hua Z(#)(6), Wang X(#)(7), Li J(#)(8), Hao C(9), Zhang L(10), Liu S(11), Wang J(12), Zhou J(13), Zhang Y(14), Li B(15), Li Y(5), Feng X(6), Li L(8), Dong Z(16), Wei W(17), Wang G(18).
Author information:
(1)National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
(2)Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
(3)Department of Epidemiology, Cancer Institute / Hospital of Ci County, Handan, China.
(4)Cancer Registry, Linzhou Cancer Hospital, Linzhou, China.
(5)Cancer Center, Feicheng People's Hospital, Feicheng, China.
(6)Cancer Institute of Yangzhong City/People's Hospital of Yangzhong City, Yangzhong, China.
(7)Yangcheng Cancer Hospital, Jincheng, China.
(8)Cancer Prevention and Treatment Office, Yanting Cancer Hospital, Mianyang, China.
(9)Department of Endoscopy, Linzhou Cancer Hospital, Linzhou, China.
(10)Endoscopy Center, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China.
(11)Department of Disease Prevention and Control, Affiliated Tumor Hospital of Zhengzhou University/Henan Cancer Hospital, Zhengzhou, China.
(12)Department of Science and Education, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, China.
(13)Department of Chronic Non⁃communicable Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
(14)Department of Epidemiology, Shanxi Cancer Hospital, Taiyuan, China.
(15)Department of Cancer Prevention and Control, Sichuan Cancer Center/Sichuan Cancer Hospital and Institute/School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
(16)National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
(17)National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China [Email] [Email]
(18)Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China [Email] [Email]
(#)Contributed equally

Abstract

OBJECTIVES: To estimate the effectiveness of endoscopic screening programme in reducing incidence and mortality of upper gastrointestinal cancer in high risks areas of China. DESIGN: This 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. 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, 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. CONCLUSION: Among 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.