The optimal starting age of endoscopic screening for esophageal squamous cell cancer in high prevalence areas in China

Feng, Hao; Song, Gonghua; Ma, Shanrui; Ma, Qing; Li, Xinqing; Wei, Wenqiang; Abnet, Christian C.; Qiao, You‐Lin; Wang, Guoqing

doi:10.1111/jgh.15090

Cited by 4 publications

(4 citation statements)

References 29 publications

(34 reference statements)

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“…Our subgroup analysis by age shows that the cumulative incidence rate in elder subjects aged 50 to 69 years had 4.4 times higher than those aged 40 to 49 years. The age 50 was chosen to be the cutoff value according to previous studies associated with ESCC, in which the one‐time endoscopy screening at age 50 years old in resource‐constrained areas may reveal higher detection rate, rendering screening programs cost‐effective 25‐27 . The studies in Japan 28 and Korea 29 also indicated that screening program for GC would be highly cost‐effective when implemented at age 50 years.…”

Section: Discussionmentioning

confidence: 99%

“…The age 50 was chosen to be the cutoff value according to previous studies associated with ESCC, in which the one-time endoscopy screening at age 50 years old in resource-constrained areas may reveal higher detection rate, rendering screening programs cost-effective. [25][26][27] The studies in Japan 28 and Korea 29 also indicated that screening program for GC would be highly cost-effective when implemented at age 50 years. Moreover, consistent with a prior study of ESCC in the same area, older subjects aged 50 to 69 years had three times higher ESCC incidence than younger subjects aged 40 to 49 years.…”

Section: Subgroup Analysis Of Cumulative Gca Incidence and Mortality ...mentioning

confidence: 99%

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Surveillance of premalignant gastric cardia lesions: A population‐based prospective cohort study in China

Xie

Wang

et al. 2021

Intl Journal of Cancer

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In our study, we aimed to assess the long‐term risk of gastric cardia adenocarcinoma (GCA) for patients with different histological cardia lesions to inform future guidelines for GCA screening in China. We conducted a population‐based prospective study among 9740 subjects who underwent upper endoscopy screening during 2005 to 2009 and followed until December 2017. Cumulative incidence and mortality rates of GCA were calculated by the baseline histological diagnoses, and the hazard ratios (HRs), overall and by age and sex, were analyzed by Cox proportional hazards models. During a median follow‐up of 10 years, we identified 123 new GCA cases (1.26%) and 31 GCA deaths (0.32%). The age‐standardized incidence and mortality rates of GCA were 128.71/100 000 and 35.69/100 000 person‐years, and cumulative incidence rate in patients with cardia high‐grade dysplasia (CHGD), cardia low‐grade dysplasia (CLGD) and atrophic carditis (AC)/cardia intestinal metaplasia (CIM) was 25%, 3.05% and 1.58%, respectively. The progression rate and cancer risk of GCA increased monotonically with each step in Correa's cascade. Individuals aged 50 to 69 years had 4.4 times higher GCA incidence than those aged 40 to 49 years. Patients with CLGD had a significantly higher 3‐year GCA incidence than the normal group, while patients with AC/CIM had a comparable GCA risk during 3‐year follow‐up but a higher risk at 5‐year intervals. Our results suggested a postponed starting age of 50 years for GCA screening, immediate treatment for patients with CHGD, a 3‐year surveillance interval for patients with CLGD, and a lengthened surveillance interval of 5 years for patients with AC/CIM.

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Section: Discussionmentioning

confidence: 99%

Section: Subgroup Analysis Of Cumulative Gca Incidence and Mortality ...mentioning

confidence: 99%

Surveillance of premalignant gastric cardia lesions: A population‐based prospective cohort study in China

Xie

Wang

et al. 2021

Intl Journal of Cancer

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“…Previous studies showed inconsistent results and were limited due to small sample size and simplistic outcome evaluation. Feng et al found that screening is effective in reducing the mortality of esophageal cancer in 40-49 and 50-59 age group and recommended that people in high prevalence area of esophageal squamous cell carcinoma (ESCC) had one time endoscopy at their 50 years since the 50-59 age group had a lower NNS 13 . Wei et al suggested that the first screening could be postponed to 50 years based on the findings that individuals aged 50-69 years had 3.1 times higher cumulative incidence of ESCC than individuals aged 40-49 years.…”

Section: Discussionmentioning

confidence: 99%

“…Given the limited and inconsistent evidence on the optimal starting age for esophageal cancer screening, 13 , 14 the aim of our study was to evaluate the impact of starting age on the effectiveness of screening through comprehensive assessment on multiple outcomes, and to provide high‐quality evidence for optimization and implementation of screening programs in China and other countries with high risk of esophageal cancer.…”

Section: Introductionmentioning

confidence: 99%

Optimal starting age of endoscopic screening for esophageal cancer in China: A multicenter prospective cohort study

et al. 2023

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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.

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Non-invasive early detection on esophageal squamous cell carcinoma and precancerous lesions by microbial biomarkers combining epidemiological factors in China

Li,

Shao,

Fan

et al. 2024

J Gastroenterol

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The optimal starting age of endoscopic screening for esophageal squamous cell cancer in high prevalence areas in China

Abstract: did the conception and design of the study. Hao Feng, Guohui Song, and Wenqiang Wei carried out the provision of study materials or patients. Hao Feng,

Cited by 4 publications

References 29 publications

Surveillance of premalignant gastric cardia lesions: A population‐based prospective cohort study in China

Surveillance of premalignant gastric cardia lesions: A population‐based prospective cohort study in China

Optimal starting age of endoscopic screening for esophageal cancer in China: A multicenter prospective cohort study

Non-invasive early detection on esophageal squamous cell carcinoma and precancerous lesions by microbial biomarkers combining epidemiological factors in China

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