Association between the National Cancer Screening Programme (NSCP) for gastric cancer and oesophageal cancer mortality

Abstract

Background: The aim was to evaluate whether this gastric cancer-screening programme was effective in reducing oesophageal cancer mortality.

Methods: A population-based retrospective cohort study was conducted using the Korean National Cancer Screening Programme (NCSP) database. The study cohort comprised 16,969 oesophageal cancer patients who had been diagnosed in 2007-2014. We analysed the association between the history of NSCP for gastric cancer and oesophageal cancer mortality.

Results: Compared with never-screened subjects, ever-screened subjects had an overall HR for oesophageal cancer mortality of 0.647 (95% CI, 0.617-0.679). According to the time interval since screening, the HRs of death were 0.731 (95% CI, 0.667-0.801) for 6-11 months, 0.635 (95% CI, 0.594-0.679) for 12-23 months, 0.564 (95% CI, 0.522-0.610) for 24-35 months and 0.742 (95% CI, 0.679-0.810) for ≥36 months. According to the last screening modality, the HRs of death were 0.497 (95% CI, 0.464-0.531) for upper endoscopy, and 0.792 (95% CI, 0.749-0.838) for UGIS. Upper endoscopy reduced the mortality consistently in all age groups over 50 years, whereas UGIS could not.

Conclusion: The NCSP for gastric cancer was effective in reducing the mortality of oesophageal cancer, and upper endoscopy was superior to UGIS.

Fig. 1. Association between screening and oesophageal cancer mortality according to the last screening modality since the last screening in comparison with never-screened individuals.

Total indicates upper endoscopy or UGIS as the last screening modality. EGD upper endoscopy, UGIS upper gastrointestinal series.