Li M J, Chen R, Wang S M, Wei W W
Department of Traumatology and Orthopaedics, Beijing Jishuitan Hospital, Capital Medical University, Beijing100035, China.
Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing100021, China.
Zhonghua Zhong Liu Za Zhi. 2025 Jan 23;47(1):94-99. doi: 10.3760/cma.j.cn112152-20231024-00231.
Esophageal cancer is one of the global public health problems, which is a serious threat to life and health. Screening is not only an important main measures to reduce the incidence and mortality of esophageal cancer, but also an effective strategy for early prevention and early treatment. There are significant differences in the screening status of esophageal adenocarcinoma and esophageal squamous cell carcinoma cancer between China and abroad. Internationally, there are several guidelines for screening and monitoring of Barrett's esophagus and esophageal adenocarcinoma, but most guidelines do not recommend screening in the general population. The primary screening by sponge ball then endoscopic diagnosis is a new focus. In China, the screening of esophageal cancer and its precancerous lesions is mainly esophageal squamous cell carcinoma, which has been relatively mature and gradually transformed from population screening to opportunistic screening. However, due to the high cost, high technical difficulty and certain invasiveness, it is difficult to popularize and be applied widely; and the canceration rate of precancerous lesions is low, so it is very important to control the cost of screening and scientific follow-up. Moreover, high-risk population should raise their awareness of cancer prevention, actively take primary prevention and the initiative to participate in screening. About medicine institutions, it is urgent to improve the awareness and capacity of early screening. The multi-disciplinary research cooperation, minimally invasive, simple and economical screening methods and multi-omics biomarkers are still explored to detect and concentrate high-risk populations, which will help to optimize screening programs of esophageal cancer and further reduce the incidence and mortality of esophageal cancer.
食管癌是全球公共卫生问题之一,严重威胁生命健康。筛查不仅是降低食管癌发病率和死亡率的重要主要措施,也是早期预防和早期治疗的有效策略。中国与国外在食管腺癌和食管鳞状细胞癌的筛查现状上存在显著差异。在国际上,有多项关于巴雷特食管和食管腺癌筛查及监测的指南,但大多数指南不建议在普通人群中进行筛查。通过海绵球进行初步筛查然后进行内镜诊断是一个新的重点。在中国,食管癌及其癌前病变的筛查主要针对食管鳞状细胞癌,已经相对成熟,且正从人群筛查逐渐转变为机会性筛查。然而,由于成本高、技术难度大且具有一定侵入性,难以推广和广泛应用;而且癌前病变的癌变率较低,因此控制筛查成本和科学随访非常重要。此外,高危人群应提高防癌意识,积极采取一级预防并主动参与筛查。对于医疗机构而言,迫切需要提高早期筛查的意识和能力。仍在探索多学科研究合作、微创、简单且经济的筛查方法以及多组学生物标志物,以检测和集中高危人群,这将有助于优化食管癌筛查方案并进一步降低食管癌的发病率和死亡率。