An initial screening strategy based on epidemiologic information in esophageal cancer screening: a prospective evaluation in a community-based cancer screening cohort in rural China
| Autor: | Jufang Shi, Jiansong Ren, Jiang Li, Xibin Sun, Jinyi Zhou, Wanqing Chen, Tiantang Shao, Jie He, Daokuan Sun, Hongmei Zeng, Chunling Zhao, He Li, Jialin Wang, Xiaoqin Cao, Rongshou Zheng, Pengli Wu, Maomao Cao, Shilin He, Pengfei Luo, Yuluan Xu, Dianqin Sun, Hengmin Ma |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
China Esophageal Neoplasms Population 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Cancer screening medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies education Early Detection of Cancer education.field_of_study business.industry Proportional hazards model Hazard ratio Gastroenterology Cancer medicine.disease 030220 oncology & carcinogenesis Propensity score matching Cohort Carcinoma Squamous Cell 030211 gastroenterology & hepatology Esophageal Squamous Cell Carcinoma business Body mass index |
| Zdroj: | Gastrointestinal endoscopy. 93(1) |
| ISSN: | 1097-6779 |
| Popis: | Background and Aims In China, regional organized esophageal cancer screening programs have been implemented since 2005. However, the implementation of these screening programs is still facing some urgent challenges, especially concerning identifying high-risk individuals. This study aimed to evaluate the risk stratification potential of the current initial assessment strategy used in a mass esophageal squamous cell carcinoma (ESCC) screening program in China. Methods A total of 43,875 participants without a previous cancer history enrolled in a mass ESCC screening program in China from 2007 to 2010 who had initial assessment results were included in this study and were followed until December 31, 2015. Eight potential risk factors for ESCC were evaluated in the initial assessment strategy. A comprehensive evaluation of the association of the initial assessment results with ESCC risk was performed by propensity score matching and Cox regression analysis. Results During a median follow-up of 5.5 years, 272 individuals developed ESCC. The high-risk population assessed at baseline had a higher risk of ESCC than the non-high-risk population, with a hazard ratio (HR) of 3.11 (95% confidence interval (CI), 2.33-4.14) after adjustment for sex, age, education level, income level, and body mass index. In addition, the initial assessment results of the high-risk population were significantly associated with the risk of all esophageal cancers (HR, 3.30; 95% CI, 2.51-4.33) and upper gastrointestinal cancers (HR, 3.03; 95% CI, 2.43-3.76). Conclusions The initial screening tool in a mass ESCC screening program in China, consisting of 8 accessible variables in epidemiologic surveys, could be helpful for the selection of asymptomatic individuals for priority ESCC screening. |
| Databáze: | OpenAIRE |
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