Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), The VIP-II Gastrointestinal Cancer Division of Medical Department, Peking University Cancer Hospital & Institute, Beijing, China.
Key laboratory of Carcinogenesis and Translational Research (Ministry of Education, China), Department of Urology, Peking University Cancer Hospital & Institute, Beijing, China.
PeerJ. 2024 Sep 27;12:e18179. doi: 10.7717/peerj.18179. eCollection 2024.
Cancer screening aims to detect and treat malignant lesions at an early stage and to prolong patients' lifetime. There is still a lack of effective cancer screening programs in China. We initiated a screening project in 2018 and this study presented the cancer screening status in China.
We conducted a cross-sectional study in one cancer-care medical center of China. The screening program included routine blood tests, plasma tumor markers, gastric endoscopy, colonoscopy, ultrasound, and computed tomography (CT) scans. Screening results were presented as sensitivity, specificity and positive predictive values (PPVs).
Twenty-three (1.46%) out of 1,576 participants were eventually diagnosed with malignant tumors or high-grade intraepithelial neoplasia (HGIN). A family history of malignancy (78.26% in diagnosed cancer and HGIN . 46.36% in the others) was the only statistically significant parameter associated with cancer detection ( = 0.002). None of the common tumor markers were associated with the cancers screened. Except for colonoscopy (50.00%) and ultrasound for renal cancer (66.67%), the sensitivities of most screening methods were 100%. The specificities of all the screening means were above 96%. Most PPVs ranged from 30-60%.
We emphasized risk stratification for early cancer screening, such as a family history of cancer. The survey illustrated that gastric endoscopy, colonoscopy, ultrasound, and lung CT for early cancer screening had high specificity, reasonable sensitivity, and PPV. We anticipated this report would motivate larger-sample studies to estimate the risk-to-benefit ratio of cancer screening and urge the establishment of a native Chinese screening project and even guidelines.
癌症筛查旨在早期发现和治疗恶性病变，延长患者的寿命。中国仍然缺乏有效的癌症筛查计划。我们于 2018 年启动了一项筛查项目，本研究介绍了中国的癌症筛查现状。
我们在中国的一家癌症治疗医疗中心进行了一项横断面研究。筛查计划包括常规血液检查、血浆肿瘤标志物、胃镜、结肠镜、超声和计算机断层扫描（CT）扫描。筛查结果以敏感性、特异性和阳性预测值（PPV）表示。
23 名（1.46%）1576 名参与者最终被诊断患有恶性肿瘤或高级上皮内瘤变（HGIN）。恶性肿瘤家族史（78.26%在确诊癌症和 HGIN 中，46.36%在其他患者中）是唯一与癌症检测相关的统计学显著参数（=0.002）。除了常见肿瘤标志物外，没有一种与筛查的癌症有关。除了结肠镜检查（50.00%）和用于肾癌的超声检查（66.67%）外，大多数筛查方法的敏感性均为 100%。所有筛查方法的特异性均高于 96%。大多数 PPV 范围在 30-60%之间。
我们强调了癌症筛查的风险分层，如癌症家族史。该调查表明，胃镜、结肠镜、超声和肺部 CT 用于早期癌症筛查具有较高的特异性、合理的敏感性和 PPV。我们预计本报告将促使更大样本的研究来评估癌症筛查的风险效益比，并敦促建立一个本土的中国筛查项目，甚至是指南。
