Wang Xiao, Fan Jin-Chuan, Wang An-Rong, Leng Yue, Li Jun, Bao Yu, Wang Ying, Yang Qing-Feng, Ren Yu
Sichuan Cancer Hospital and Institute, Chengdu, China.
Asian Pac J Cancer Prev. 2013;14(4):2429-32. doi: 10.7314/apjcp.2013.14.4.2429.
Yanting in Sichuan Province is one of the highest risk areas of esophageal cancer (EC) in the world. We here summarize the epidemiology of EC in Yanting using data from the national screening programme during 2006-2011.
Random cluster sampling was used to select a proportion of natural villages from six towns in Yanting, and residents aged 40-69 years old were invited for screening. Participants were screened using endoscopy with iodine staining and then confirmed by histological examinations.
The overall detection rates of low-grade hyperplasia (LH), moderate hyperplasia (MH), high-grade hyperplasia (HH), carcinoma in situ (CIS), intramucosal carcinoma (IC) and invasive carcinoma (INC) were 5.33%, 1.28%, 0.68% , 0.15% , 0.06% and 0.29%, respectively. The detection rates of LH, MH, HH and INC increased with age, reaching the peak among those aged 60-65 years, and the prevalences of LH and MH were higher among men than among women. In addition, the detection rates of hyperplasia were much higher in mountainous than in hilly areas.
Among the high risk population, there are a great number of people with early-stage EC or precancerous conditions who do not have presenting symptoms. In particular, the elderly, men, or those living in mountainous areas are the most vulnerable population. It is therefore important to reinforce health education and screening services among such high risk populations.
四川省盐亭县是全球食管癌(EC)风险最高的地区之一。我们在此利用2006 - 2011年全国筛查项目的数据总结盐亭县食管癌的流行病学情况。
采用随机整群抽样方法从盐亭县六个镇选取一定比例的自然村落,并邀请40 - 69岁的居民参加筛查。参与者接受碘染色内镜检查,随后进行组织学检查以确诊。
低级别上皮内瘤变(LH)、中级别上皮内瘤变(MH)、高级别上皮内瘤变(HH)、原位癌(CIS)、黏膜内癌(IC)和浸润癌(INC)的总体检出率分别为5.33%、1.28%、0.68%、0.15%、0.06%和0.29%。LH、MH、HH和INC的检出率随年龄增长而升高,在60 - 65岁人群中达到峰值,且男性的LH和MH患病率高于女性。此外,山区的上皮内瘤变检出率远高于丘陵地区。
在高危人群中,有大量早期食管癌或癌前病变患者没有症状表现。特别是老年人、男性或居住在山区的人群是最脆弱的群体。因此,加强对此类高危人群的健康教育和筛查服务非常重要。