在中国前瞻性随访的高危人群中，重复内镜筛查对胃癌死亡率无影响。

No impact of repeated endoscopic screens on gastric cancer mortality in a prospectively followed Chinese population at high risk.

作者信息

Riecken B, Pfeiffer R, Ma J L, Jin M L, Li J Y, Liu W D, Zhang L, Chang Y S, Gail M H, You W C

机构信息

Department of Gastroenterology and Hepatology, Freiburg University Hospital, Freiburg, Germany.

出版信息

Prev Med. 2002 Jan;34(1):22-8. doi: 10.1006/pmed.2001.0925.

DOI:10.1006/pmed.2001.0925

PMID:11749093

Abstract

BACKGROUND

Gastric cancer (GC) is the leading cause of cancer deaths in China. Our study prospectively evaluated the impact of repeated endoscopic screens on GC mortality in a high-risk population in China.

METHODS

Between 1989 and 1999, a population-based gastroscopic screening was conducted in 4,394 residents of Linqu County, China, a region with the highest rates of GC worldwide. Residents ages 35 to 64 years received initial gastroscopies with biopsies in 1989. Repeated endoscopies were performed in 1994 and 1999. Cancer occurrences and deaths were actively monitored throughout the entire period until July 2000. Mortality from GC was compared with expected values based on mortality rates obtained for Linqu in the 1990-1992 Chinese Cancer Mortality Survey.

RESULTS

Between March 1989 and July 2000, 39,303 person-years were accumulated; 85 new GCs occurred, 29 (34.5%) were in early stage. Fifty-eight cases (68%) were identified at one of the screens. The number of observed deaths from GC (37) was close to the expected (36.8). The standardized mortality ratio was 1.01 (95% CI 0.72-1.37) for the entire cohort, 1.13 (95% CI 0.77-1.57) for males, and 0.65 (95% CI 0.26-1.32) for females.

CONCLUSIONS

Despite high population coverage with repeated screens, no reduction in GC mortality was observed in this high-risk population in China.

摘要

背景

胃癌是中国癌症死亡的主要原因。我们的研究前瞻性地评估了重复内镜筛查对中国高危人群胃癌死亡率的影响。

方法

1989年至1999年期间，在中国临朐县对4394名居民进行了基于人群的胃镜筛查，临朐县是全球胃癌发病率最高的地区之一。1989年，35至64岁的居民接受了初次胃镜检查并取活检。1994年和199年进行了重复内镜检查。在整个期间直至2000年7月，对癌症的发生和死亡情况进行了积极监测。将胃癌死亡率与基于1990 - 1992年中国癌症死亡率调查中临朐县获得的死亡率得出的预期值进行比较。

结果

1989年3月至2000年7月期间，累积了39303人年；发生了85例新的胃癌病例，其中29例（34.5%）为早期。58例（68%）病例是在其中一次筛查中发现的。观察到的胃癌死亡人数（37例）接近预期值（36.8例）。整个队列的标准化死亡率为1.01（95%可信区间0.72 - 1.37），男性为l.13（95%可信区间0.77 - 1.57），女性为0.65（95%可信区间0.26 - 1.32）。