Determinants of participation and detection rate of upper gastrointestinal cancer from population‐based screening program in China

Abstract

Upper gastrointestinal cancer (UGC) screening has been widely implemented in many Asian countries. However, there is little evidence of participation and diagnostic yields in population‐based UGC screening in China. The participation rate and detection of upper gastrointestinal lesions in this program were reported and related factors were explored. The analysis was conducted in the context of the Cancer Screening Program in Urban China, which recruited 179 002 eligible participants aged 40‐74 years from three cities in Henan province from 2013 to 2017. A total of 43 423 participants were evaluated to be high risk for esophageal cancer or gastric cancer by an established risk score system and were subsequently recommended for endoscopy. Of 43 423 with high risk for UGC, 7996 subjects undertook endoscopy (participation rate of 18.4%). We found that male sex, high level of education, marriage, smoking, current alcohol drinking, lack of physical activity, history of upper gastrointestinal system disease, and family history of UGC were associated with increased participation of endoscopy screening. Overall, 15 UGC (0.19%), 275 squamous epithelial dysplasia (3.44%), and 33 intraepithelial neoplasm (0.41%) cases were detected. Several factors including age, sex, smoking, current alcohol drinking, lack of physical activity, and dietary intake of processed meat were identified to be associated with the presence of upper gastrointestinal lesions. Health promotion campaigns targeting the specific group of individuals identified in our study will be helpful for improvement of the adherence of UGC screening in population‐based cancer screening programs. Participant rate and yield of UGC screening will provide important references for evaluating the effectiveness and cost‐effectiveness of cancer screening in China.

Evaluation of a Low-Dose Computed Tomography Lung Cancer Screening Program in Henan, China

“…The study methods are described elsewhere. 5 In brief, residents aged 40 to 74 years living in the selected communities of the 8 participating cities were approached by trained staff by means of telephone calls and personal encounter. Social media and community advertisement were used to raise the public awareness of this cancer screening program.…”

“…In October 2012, the National Health Committee of China announced the launch of the Cancer Screening Program in Urban China (CanSPUC), which targets 6 types of cancer that are most prevalent in urban areas, including lung cancer, female breast cancer, esophageal cancer, gastric cancer, colorectal cancer, and liver cancer. 5 Eligible participants are recruited in the communities of the study regions and are invited to undergo cancer screening free of charge. Participants are first invited to take a cancer risk assessment using an established clinical cancer risk score system, and those who are evaluated to be at high risk for specific types of cancer are recommended to take the appropriate screening intervention per the study protocol.…”

Determinants of Participation and Detection Rate of Colorectal Cancer From a Population-Based Screening Program in China

“…CanSPUC is an ongoing national cancer screening program launched in October 2013 in Henan province of China. Study methods have been described elsewhere (10). In short, social media and community advertising were used to raise public awareness about the cancer screening process.…”

“…Since October 2012, the Chinese government has launched a population-based Cancer Screening Program in Urban China (CanSPUC). Except for CRC, lung cancer, female breast cancer, liver cancer, esophageal cancer, and gastric cancer were all targeted (10). Henan started this program in 2013.…”

Satisfaction in Population-Based Cancer Screening in a Chinese Rural High-Risk Population: The Yangzhong Early Diagnosis and Treatment of Upper Gastrointestinal Cancer

“…To maximize the bene ts of cancer screening, the targeted population must participate in it as much as possible, which places high demands on population adherence. However, the participation rate of the targeted population in the UGC screening programme in Henan province, China, has been reported to be only 18.4% [14]. A project summary of UGC screening reported that the quality of screening services in China was not optimistic, characterized by low early diagnosis rates, low 5-year survival rates, weak service levels and poor population adherence, especially in rural areas [15].…”