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Effectiveness of Endoscopic Screening in Reducing Esophageal Cancer Mortality: A Nested Case-control Study

openalex(2023)

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Abstract
Abstract Purpose To evaluate the effectiveness of endoscopic screening in reducing esophageal cancer mortality within a high-incidence area. Methods A nested case-control study was conducted based on the Upper Gastrointestinal Cancer Screening Program of Feicheng City. Based on the screening population cohort, individuals who were newly diagnosed with esophageal cancer from September 2006 to December 2016 and died of esophageal cancer before December 2018 as case subjects. Each case matched 4 controls (Subjects who were alive on the date of death of the corresponding case) based on age, gender and screening village. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated via conditional logistic analysis. Results This study included 345 cases (270 men and 75 women) and 1380 matched controls (1,080 men and 300 women). Compared with individuals who were never screened, the total ORs was 0.52(CI 0.39-0.70) for participants, the OR of screened subjects 40 to 49 years old was 0.34 (CI 0.17-0.67), and the OR for dying from esophageal cancer among individuals who were diagnosed 2 to 4 years was 0.30 (CI 0.17-0.53). Conclusions Participating in endoscopic screening could reduce the risk of death from esophageal cancer by 48%. The screening effect was related to the age of screening and the period from the screening to the date of diagnosis.
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要点】:本研究通过巢式病例对照研究评估了内镜筛查在高发区域降低食管癌死亡率的有效性,结果显示内镜筛查可降低48%的食管癌死亡风险,且筛查效果与筛查年龄及诊断间隔时间相关。

方法】:基于肥城市上消化道癌症筛查项目的筛查人群队列,采用巢式病例对照研究方法,对2006年9月至2016年12月间新诊断的食管癌患者及2018年12月前因食管癌死亡的患者进行配对分析。

实验】:研究纳入了345例病例和1380例对照,通过条件逻辑回归分析计算比值比(OR)和95%置信区间(CI),结果显示筛查过的个体总OR值为0.52,40至49岁筛查个体的OR值为0.34,诊断后2至4年内死亡的风险OR值为0.30。数据来源于肥城市上消化道癌症筛查项目。