The strategy for esophageal cancer control in high-risk areas of China.
Even though the mortality from esophageal cancer has decreased during the last two decades nationwide in China, the mortality from esophageal cancer in high-risk areas is still at a high level. Moreover, the 5-year survival rate of patients with resectable esophageal cancer after treatment ranges between 20 and 30%, as majority of patients with esophageal cancer were diagnosed in late stages. Therefore, esophageal cancer control in high-risk areas in China remains a critical task. A strategy is proposed that the high-risk population would be screened by endoscopy with mucosal iodine staining and biopsy of all unstained lesions and diagnosis of severe dysplasia carcinoma in situ, and intra-mucosal carcinoma could be cured by radical mucosectomy. A pilot study showed that the strategy is feasible and cost-effective for the high prevalence of premalignant lesions and carcinomas in early stages. It would be expected that the mortality from esophageal cancer could be decreased in high-risk areas if the proposed strategy is carried out on a large scale.
Dong
Zhiwei
Z
Department of Epidemiology, Cancer Institute and Hospital (CI/H), Chinese Academy of Medical Sciences (CAMS), Beijing, China.
Tang
Pingzhang
P
Li
Liandi
L
Wang
Guoqing
G
D001706:Biopsy; D002681:China / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control*; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology; D006293:Health Promotion; D006801:Humans; D012306:Risk; D015996:Survival Rate