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国家癌症筛查计划(NSCP)与胃癌和食管癌死亡率的关联。

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

机构信息

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Department of Biostatistics, The Catholic University, Seoul, Korea.

出版信息

Br J Cancer. 2020 Aug;123(3):480-486. doi: 10.1038/s41416-020-0883-x. Epub 2020 May 13.

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.

摘要

背景

本研究旨在评估胃癌筛查方案是否能有效降低食管癌死亡率。

方法

采用韩国国家癌症筛查计划(NCSP)数据库进行基于人群的回顾性队列研究。研究队列纳入了 2007 年至 2014 年期间被诊断为食管癌的 16969 例患者。我们分析了 NCSP 胃癌筛查史与食管癌死亡率之间的关联。

结果

与从未筛查者相比,曾筛查者的食管癌总死亡风险比(HR)为 0.647(95%可信区间,0.617-0.679)。按筛查后时间间隔分层,死亡风险 HR 分别为 6-11 个月时为 0.731(95%可信区间,0.667-0.801),12-23 个月时为 0.635(95%可信区间,0.594-0.679),24-35 个月时为 0.564(95%可信区间,0.522-0.610),≥36 个月时为 0.742(95%可信区间,0.679-0.810)。按最近筛查方式分层,死亡风险 HR 分别为上消化道内镜检查时为 0.497(95%可信区间,0.464-0.531),上消化道内视镜检查时为 0.792(95%可信区间,0.749-0.838)。上消化道内镜检查在所有年龄≥50 岁的人群中均能持续降低死亡率,而上消化道内视镜检查则不然。

结论

NCSP 胃癌筛查方案可有效降低食管癌死亡率,上消化道内镜检查优于上消化道内视镜检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6388/7403142/7765d69d8520/41416_2020_883_Fig1_HTML.jpg

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