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The optimal starting age of endoscopic screening for esophageal squamous cell cancer in high prevalence areas in China
Author(s) -
Feng Hao,
Song Guohui,
Ma Shanrui,
Ma Qing,
Li Xinqing,
Wei Wenqiang,
Abnet Christian,
Qiao Youlin,
Wang Guoqing
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15090
Subject(s) - medicine , squamous cell cancer , esophageal cancer , esophageal squamous cell carcinoma , china , cancer , political science , law
Background and Aim This study aimed to evaluate effects of endoscopic screening method in different starting age groups and further confirm the optimum starting age for esophageal squamous cell cancer (ESCC) screening. Methods This study received institutional review board approval, and 6825 residents aged 40 to 69 years in high prevalence communities were assigned to the screening group or the control (non‐screening) group from Hebei, China. Cumulative mortalities during the 14‐year period, relative risk for participants who underwent screening, and numbers needed to invite for screening to save one life were compared between the screening group and the control group of different starting age groups at 14‐year follow‐up. Results The 14‐year risks of ESCC mortality were one in 55, one in 17, and one in 9 for a person screened in the starting age group of 40, 50, and 60 years old. The cumulative mortalities of ESCC in screening groups were significantly lower than control groups in starting age groups of 40 years (1.42% vs 2.38%, P = 0.033) and 50 years (4.18% vs 7.13%, P = 0.005). Relative risks for participants who underwent screening were 0.60 and 0.59 for the starting age groups of 40 and 50 years. Numbers needed to invite for screening to save one life were 104 and 34 for participants in 40 years old group and 50 years old group, respectively. Conclusions In conclusion, people in high prevalence area of ESCC should have endoscopy screening once at their 50 years. Forty years will be preferably defined as the starting age for screening in areas with sufficient health resources.