Nutrition for Cancer Prevention and Control: A Review of Dietary Risk Factors and Protective Measures

Abstract

Endoscopic biopsy and histopathological examination remain one of the critical methods for high-risk subjects (HRS) screening for esophageal squamous cell carcinoma (ESCC) in symptom-free subjects (SFS) of high-incidence areas (HIA) for ESCC. Almost 90% of the symptom-free residents show normal esophageal epithelia in HIA of ESCC. Based on that, overexamination by endoscopy was found in the screening of early ESCC. Furthermore, in large-scale screening on SFS in HIA of ESCC, the application of endoscopy is limited because of the complicated protocol, high cost, and shortage of experienced endoscopists. The authors suggest a two-step screening method. The first step involves a non-invasive serological screening by which to determine the blood level of neoplasm-related molecules which indirectly reflects the esophageal epithelial lesions. Endoscopic and histopathological examinations are involved in the second step. The second step will decrease the screening cost and improve the effectiveness of endoscopic examination for large-scale screening in HIA of ESCC. It is crucial to combine the two steps within a cooperative medical system in rural villages and communities in cities for extensive application.