Community-Based Upper Gastrointestinal Cancer Screening in a Randomized Controlled Trial: Baseline Results in a Non-high-incidence Area

Abstract

A cluster-randomized controlled trial (RCT) was conducted to evaluate to the effectiveness of reducing mortality of upper gastrointestinal cancer (UGC) and feasibility of screening through a questionnaire combined with endoscopy in non-high-incidence urban areas in China. The trial design, recruitment performance, and preliminary results from baseline endoscopy are reported. Seventy-five communities in two urban cities with a nonhigh-incidence of UGC were randomized to a screening endoscopy arm (n ¼ 38) or a control arm (n ¼ 37). In the screening arm, individuals at high risk of UGC underwent endoscopic screening. The primary outcome was the UGC mortality, and secondary outcomes included the UGC detection rate, incidence rate, survival rate, and clinical stage at the time of diagnosis. A total of 10,416 and 9,565 individuals were recruited into the screening and control

Development and external validation of a nomogram to predict the risk of Upper gastrointestinal precancerous lesions in a non‐high‐incidence area

“…The detailed requirements see our previous study. 16 We freely provided to subjects for normal endoscopy performed under without anesthesia.…”

“…Within China, striking geographic variations exist in the incidences of UGC, which can vary more than 10‐fold in different regions 14,15 . Hunan province, as non‐high‐incidence area, also stated this program at 2012 with serious disease burden of UGC 16 . Our previous cluster randomized trial showed that the questionnaire evaluation could not effectively concentrate the UGC high‐risk individuals 16 .…”

“…14,15 Hunan province, as non-high-incidence area, also stated this program at 2012 with serious disease burden of UGC. 16 Our previous cluster randomized trial showed that the questionnaire evaluation could not effectively concentrate the UGC high-risk individuals. 16 Furthermore, risk factors of this questionnaire evaluation are similar to the CanSPUC whose questionnaire was designed mostly based on the evidence from high-incidence area in China.…”

“…16 Our previous cluster randomized trial showed that the questionnaire evaluation could not effectively concentrate the UGC high-risk individuals. 16 Furthermore, risk factors of this questionnaire evaluation are similar to the CanSPUC whose questionnaire was designed mostly based on the evidence from high-incidence area in China. So the questionnaire evaluation is probably not suitable for the people in non-high-incidence area, and we need a more simple and accurate evaluation system as primary screening tool.…”

Frontiers of Robotic Gastroscopy: A Comprehensive Review of Robotic Gastroscopes and Technologies

“…Nevertheless, the detection rate of early UGI tract cancer, with conventional esophagogastroduodenoscopy, remains low [ 9 ]. Although new online learning platforms have been introduced to help gastroenterologists to master their diagnostic skills in endoscopic detection of early UGI tract disease and to allow for more favourable outcomes [ 10 ], the roll-out of mass-screening is difficult and often hampered by a relatively low compliance rate [ 11 ]. Furthermore, meta-analyses demonstrated that around 10% of UGI cancers are missed during endoscopy exams performed within 3 years before diagnosis [ 12 , 13 , 14 ].…”