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

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.