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Multicenter Study
. 2021 Feb;70(2):251-260.
doi: 10.1136/gutjnl-2019-320200. Epub 2020 Apr 2.

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

Ru Chen #  1 , Yong Liu #  2 , Guohui Song #  3 , Bianyun Li #  4 , Deli Zhao #  5 , Zhaolai Hua #  6 , Xinzheng Wang #  7 , Jun Li #  8 , Changqing Hao  9 , Liwei Zhang  10 , Shuzheng Liu  11 , Jialin Wang  12 , Jinyi Zhou  13 , Yongzhen Zhang  14 , Bo Li  15 , Yanyan Li  5 , Xiang Feng  6 , Lin Li  8 , Zhiwei Dong  16 , Wenqiang Wei  17 , Guiqi Wang  18
Affiliations
Multicenter Study

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

Ru Chen et al. Gut. 2021 Feb.

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.

Keywords: endoscopy; gastric cancer; oesophageal cancer; screening.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Cohort profile. AC;all-site cancer; CC; cardiagastric cancer; EC, oesophagealcancer; GC; non-cardiagastric cancer; UC, uppergastrointestinal cancer.
Figure 2
Figure 2
Cumulative incidence of upper gastrointestinal cancer, oesophageal cancer, non-cardia gastric cancer and cardia gastric cancer.
Figure 3
Figure 3
Cumulative mortality from upper gastrointestinal cancer, oesophageal cancer, non-cardia gastric cancer and cardia gastric cancer.
Figure 4
Figure 4
Relative risks for different cancer type in screened versus control groups by age group and sex.
See this image and copyright information in PMC

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