Optimal starting age of endoscopic screening for esophageal cancer in China: A multicenter prospective cohort study
Abstract Background Although endoscopic screening for esophageal cancer has been performed in high‐risk areas in China for decades, there is limited and inconsistent evidence regarding the starting age for individuals participating in screening. The aim of this study is to investigate the optimal st...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-04-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.5727 |
| _version_ | 1797831077647089664 |
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| author | Ru Chen Lizhou Dou Jiachen Zhou Guohui Song Bianyun Li Deli Zhao Zhaolai Hua Xinzheng Wang Jun Li Changqing Hao Yanyan Li Xiang Feng Lin Li Wenqiang Wei Guiqi Wang |
| author_facet | Ru Chen Lizhou Dou Jiachen Zhou Guohui Song Bianyun Li Deli Zhao Zhaolai Hua Xinzheng Wang Jun Li Changqing Hao Yanyan Li Xiang Feng Lin Li Wenqiang Wei Guiqi Wang |
| author_sort | Ru Chen |
| collection | DOAJ |
| description | Abstract Background Although endoscopic screening for esophageal cancer has been performed in high‐risk areas in China for decades, there is limited and inconsistent evidence regarding the starting age for individuals participating in screening. The aim of this study is to investigate the optimal starting age of esophageal cancer screening. Methods This study is based on a multicenter prospective cohort consisting 338,017 permanent residents aged 40–69 years in six high‐risk areas of esophageal cancer in China. The participation rate, detection rate, hazard ratios (HRs), cumulative incidence and mortality and number needed to screen (NNS) were calculated in each age group. Screening burden, benefit and risk were compared among screening strategies with different initiation ages to explore the optimal starting age for population‐based screening in high‐risk areas. Results Individuals aged 50–69 had a higher participation rate, a higher detection rate and improved screening effectiveness than those aged 40–49. The endoscopic screening had no significant effect on reducing the incidence of esophageal cancer in individuals under 55 and mortality in individuals under 45. Increasing the starting age to 50 years reduced the screening demand and NNS by 40% and 55%, and resulted in 12% of detectable positive cases, 16% of preventable incident cases, and 14% of preventable deaths being missed. Conclusions Postponing the starting age of endoscopic screening to 50 years might yield a more‐favorable balance between screening benefit and burden in high‐ risk areas with limited resources. |
| first_indexed | 2024-04-09T13:46:16Z |
| format | Article |
| id | doaj.art-b5b09209a0744b6d83d704bcb16906a7 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-09T13:46:16Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-b5b09209a0744b6d83d704bcb16906a72023-05-09T04:04:19ZengWileyCancer Medicine2045-76342023-04-011289988999810.1002/cam4.5727Optimal starting age of endoscopic screening for esophageal cancer in China: A multicenter prospective cohort studyRu Chen0Lizhou Dou1Jiachen Zhou2Guohui Song3Bianyun Li4Deli Zhao5Zhaolai Hua6Xinzheng Wang7Jun Li8Changqing Hao9Yanyan Li10Xiang Feng11Lin Li12Wenqiang Wei13Guiqi Wang14National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Epidemiology and Biostatistics School of Public Health, Xi'an Jiaotong University Health Science Center Xi'an Shaanxi ChinaCixian Cancer Hospital/Cixian Institute for Cancer Prevention and Control Handan ChinaLinzhou Cancer Hospital Anyang ChinaFeicheng People's Hospital Taian ChinaCancer Institute of Yangzhong City/People's Hospital of Yangzhong City Zhenjiang ChinaYangcheng Cancer Hospital Jincheng ChinaYanting Cancer Hospital Mianyang ChinaLinzhou Cancer Hospital Anyang ChinaFeicheng People's Hospital Taian ChinaCancer Institute of Yangzhong City/People's Hospital of Yangzhong City Zhenjiang ChinaYanting Cancer Hospital Mianyang ChinaNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaAbstract Background Although endoscopic screening for esophageal cancer has been performed in high‐risk areas in China for decades, there is limited and inconsistent evidence regarding the starting age for individuals participating in screening. The aim of this study is to investigate the optimal starting age of esophageal cancer screening. Methods This study is based on a multicenter prospective cohort consisting 338,017 permanent residents aged 40–69 years in six high‐risk areas of esophageal cancer in China. The participation rate, detection rate, hazard ratios (HRs), cumulative incidence and mortality and number needed to screen (NNS) were calculated in each age group. Screening burden, benefit and risk were compared among screening strategies with different initiation ages to explore the optimal starting age for population‐based screening in high‐risk areas. Results Individuals aged 50–69 had a higher participation rate, a higher detection rate and improved screening effectiveness than those aged 40–49. The endoscopic screening had no significant effect on reducing the incidence of esophageal cancer in individuals under 55 and mortality in individuals under 45. Increasing the starting age to 50 years reduced the screening demand and NNS by 40% and 55%, and resulted in 12% of detectable positive cases, 16% of preventable incident cases, and 14% of preventable deaths being missed. Conclusions Postponing the starting age of endoscopic screening to 50 years might yield a more‐favorable balance between screening benefit and burden in high‐ risk areas with limited resources.https://doi.org/10.1002/cam4.5727cohortendoscopic screeningesophageal cancerhigh risk areasstarting age |
| spellingShingle | Ru Chen Lizhou Dou Jiachen Zhou Guohui Song Bianyun Li Deli Zhao Zhaolai Hua Xinzheng Wang Jun Li Changqing Hao Yanyan Li Xiang Feng Lin Li Wenqiang Wei Guiqi Wang Optimal starting age of endoscopic screening for esophageal cancer in China: A multicenter prospective cohort study Cancer Medicine cohort endoscopic screening esophageal cancer high risk areas starting age |
| title | Optimal starting age of endoscopic screening for esophageal cancer in China: A multicenter prospective cohort study |
| title_full | Optimal starting age of endoscopic screening for esophageal cancer in China: A multicenter prospective cohort study |
| title_fullStr | Optimal starting age of endoscopic screening for esophageal cancer in China: A multicenter prospective cohort study |
| title_full_unstemmed | Optimal starting age of endoscopic screening for esophageal cancer in China: A multicenter prospective cohort study |
| title_short | Optimal starting age of endoscopic screening for esophageal cancer in China: A multicenter prospective cohort study |
| title_sort | optimal starting age of endoscopic screening for esophageal cancer in china a multicenter prospective cohort study |
| topic | cohort endoscopic screening esophageal cancer high risk areas starting age |
| url | https://doi.org/10.1002/cam4.5727 |
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