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Endoscopy screening effect on stage distributions of esophageal cancer: a cluster randomized cohort study in China.

Endoscopy screening effect on stage distributions of esophageal cancer: a cluster randomized cohort study in China.
Author Information (click to view)

Guan CT, Song GH, Li BY, Gong YW, Hao CQ, Xue LY, Chen WQ, Wei WQ,


Guan CT, Song GH, Li BY, Gong YW, Hao CQ, Xue LY, Chen WQ, Wei WQ, (click to view)

Guan CT, Song GH, Li BY, Gong YW, Hao CQ, Xue LY, Chen WQ, Wei WQ,

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Cancer science 2018 04 10() doi 10.1111/cas.13606

Abstract

The efficacy of endoscopy screening for esophageal cancer is not definitive enough and lacks of randomized controlled trial evidence. This study was to prove the short-term screening efficacy through describing and comparing disease stage distributions of intervention and control population. Villages from Linzhou and Cixian were cluster randomly allocated to the intervention or control group, covering 40-69 years old target population of 52729 and 43068, and the actual enrolled number were 18316 and 21178. TNM stage information and study-defined stage information of esophageal cases occurred from 2012 to 2016 were collected. The stage distributions were compared between intervention and control group in the total target population, as well as subgroup populations in terms of whether enrolled or not and before or after intervention. There were totally 199 and 141 esophageal cancer cases in intervention and control group. For the target population, the distributions of TNM stage were borderline significant between two groups after intervention (p=0.093). But the subgroup analysis of enrolled population during after-intervention period have statistical significance for both TNM and study-defined stage. The natural TNM stage distribution were about 32%, 41%, 24% and 3% for stage I to IV, versus 71%, 19%, 7% and 3% in intervention population; The natural study-defined stage distribution from early, middle to advanced stage were about 18%, 49% and 33%, versus 59%, 33% and 8%. Early stage esophageal cancer cases accounted for a higher proportion after endoscopy screening, and the efficacy in target population depends on the intervention compliance. This article is protected by copyright. All rights reserved.

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