National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Gut. 2021 Feb;70(2):251-260. doi: 10.1136/gutjnl-2019-320200. Epub 2020 Apr 2.
To estimate the effectiveness of endoscopic screening programme in reducing incidence and mortality of upper gastrointestinal cancer in high risks areas of China.
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.
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.
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.
评估内镜筛查方案在中国高发地区减少上消化道癌发病率和死亡率的效果。
这是一项多中心、基于人群的队列研究，于 2005 年至 2015 年在中国六个地区进行。所有 40 至 69 岁的常住居民均被确定为目标人群。我们将受邀进行筛查的人群称为邀请组。在这些人中，我们将受邀并接受内镜筛查的人群定义为筛查组，将受邀但未接受筛查的人群定义为未筛查组。未被邀请参加筛查的目标人群被分配到对照组。通过比较筛查组和邀请组与对照组上消化道癌发病率和死亡率的降低，评估内镜筛查和筛查方案的效果。
我们的队列分析包括 637500 人：对照组 299483 人，受邀筛查组 338017 人，其中 113340 人（33.53%）最终接受了筛查。与对照组相比，筛查组上消化道癌发病率和死亡率分别降低了 23%（相对风险（RR）=0.77，95%置信区间（CI）0.74 至 0.81）和 57%（RR=0.43，95%CI 0.40 至 0.47），受邀组分别降低了 14%（RR=0.86，95%CI 0.84 至 0.89）和 31%（RR=0.69，95%CI 0.66 至 0.72）。
在上消化道癌高危地区年龄在 40 至 69 岁的人群中，一次性内镜筛查方案与上消化道癌发病率和死亡率的显著降低相关。
