title: Screening for oesophageal cancer.
abstract: BACKGROUND
  Oesophageal cancer is a global heath problem. The prognosis for advanced oesophageal cancer is generally unfavourable, but early-stage asymptomatic oesophageal cancer is basically curable and could achieve better survival rates. The two most commonly used tests are cytologic examination and endoscopy with mucosal iodine staining. The efficacy of the screening tests is controversial, and the true benefit and efficacy of screening remains uncertain because of the potential lead-time and length-time biases. This review was conducted to examine the evidence for the efficacy of screening for oesophageal cancer (squamous cell carcinoma and adenocarcinoma).
  
  
  OBJECTIVE
  To determine the efficacy of early screening, using endoscopy with iodine staining or cytologic examination, in reducing mortality from oesophageal cancer in asymptomatic individuals from high-risk and general populations.
  
  
  METHODS
  We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2012, Issue 8), The Cochrane Library (2012, Issue 8), MEDLINE (1950 to August 2012), EMBASE (1980 to August 2012), Allied and Complementary Medicine (AMED) (1985 to August 2012), Chinese Biomedical Database (CBM) (January 1975 to August 2012), VIP Database (January 1989 to August 2012), China National Knowledge Infrastructure (CNKI) (January 1979 to August 2012), and the Internet. We also searched reference lists, conference proceedings, and databases of ongoing trials. There was no restriction on language or publication status in the search for trials.
  
  
  METHODS
  We included only randomised controlled trials (RCT) of screening versus no screening for oesophageal cancer. Randomisation of groups or clusters of individuals was acceptable.
  
  
  METHODS
  Two review authors independently scanned the titles and abstracts from the initial search for potential trials for inclusion. We did not find any trials that met the inclusion criteria.
  
  
  RESULTS
  The electronic search identified 3482 studies. Two authors independently reviewed the references. The reports of 18 studies were retrieved for further investigation. None met the eligibility criteria for a RCT investigation of the effects of screening versus no screening for oesophageal cancer.
  
  
  CONCLUSIONS
  There were no RCTs that determined the efficacy of screening for oesophageal cancer. Non-RCTs showed a high incidence and the reported better survival after screening could be caused by selection bias, lead-time and length-time biases. RCTs are needed to determine the efficacy of screening for oesophageal cancer.
authors.affiliation: West China School of Public Health, Sichuan University, Chengdu, China. rekinyyang@yahoo.com.cn.
authors.forename: Shujuan
authors.initials: S
authors.lastname: Yang
authors.forename: Siying
authors.initials: S
authors.lastname: Wu
authors.forename: Yuchuan
authors.initials: Y
authors.lastname: Huang
authors.forename: Ying
authors.initials: Y
authors.lastname: Shao
authors.forename: Xiao Y
authors.initials: XY
authors.lastname: Chen
authors.forename: Liu
authors.initials: L
authors.lastname: Xian
authors.forename: Jianwei
authors.initials: J
authors.lastname: Zheng
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Wen
authors.forename: Xinyue
authors.initials: X
authors.lastname: Chen
authors.forename: Huangyuan
authors.initials: H
authors.lastname: Li
authors.forename: Chunxia
authors.initials: C
authors.lastname: Yang
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D004938:Esophageal Neoplasms / Q000175:diagnosis*; D004945:Esophagoscopy; D006801:Humans; D007455:Iodine; D013194:Staining and Labeling
chemical_list: D007455:Iodine