title: Massive Endoscopic Screening for Esophageal and Gastric Cancers in a High-Risk Area of China.
abstract: OBJECTIVE
  This study aims to describe the findings from a massive endoscopic screening program in a high-risk area of China and to evaluate the prognosis of patients diagnosed through endoscopic screening compared with those diagnosed at usual hospital visits because of illness.
  
  
  METHODS
  In 2006, an early detection and treatment program was initiated in Yangzhong county, China. Local residents aged 40-69 years were eligible for free endoscopic screening. Endoscopic examination was performed with Lugol's iodine staining, followed by biopsies. Patients diagnosed with esophageal or gastric cancer were referred for treatment and followed to assess their long-term survival status.
  
  
  RESULTS
  From 2006 through 2012, we screened 12453 participants, including 5334 (42.8%) men and 7119 (57.2%) women. The average age was 52.8 ± 8.0 years. We detected 166 patients with upper digestive tract cancers, including 106 cancers in the esophagus (detection rate: 0.85%) and 60 cancers in the stomach (detection rate: 0.48%). Of these patients, 98.11% with esophageal cancer and 100% with gastric cancer were defined as at the early stage. In the process of follow-up, 17 patients died from cancer-related causes, and the median survival time was greater than 85 months. The overall survival rates for 1, 3 and 5 years were 98.0%, 90.0% and 89.0%, respectively. A significant positive effect was observed for the long-term survival of patients diagnosed through massive endoscopic screening.
  
  
  CONCLUSIONS
  In a high-risk population, massive endoscopic screening can identify early stage carcinoma of esophageal and gastric cancers and improve patients' prognosis through early detection and treatment.
authors.affiliation: Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
authors.forename: Xianzhi
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Department of Clinical Laboratory, Yixing People's Hospital, Wuxi, 214200, China.
authors.forename: Xuhua
authors.initials: X
authors.lastname: Mao
authors.affiliation: Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Xu
authors.affiliation: Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
authors.forename: Lingshuang
authors.initials: L
authors.lastname: Lü
authors.affiliation: Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
authors.forename: Xianzhen
authors.initials: X
authors.lastname: Peng
authors.affiliation: Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
authors.forename: Guisheng
authors.initials: G
authors.lastname: Xu
authors.affiliation: Yangzhong Cancer Research Institute, Yangzhong People's Hospital, Yangzhong, 212200, China.
authors.forename: Zhaolai
authors.initials: Z
authors.lastname: Hua
authors.affiliation: Yangzhong Cancer Research Institute, Yangzhong People's Hospital, Yangzhong, 212200, China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Wang
authors.affiliation: Yangzhong Cancer Research Institute, Yangzhong People's Hospital, Yangzhong, 212200, China.
authors.forename: Hengchuan
authors.initials: H
authors.lastname: Xue
authors.affiliation: Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.|Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.|The Innovation Center for Social Risk Governance in Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
authors.forename: Jianming
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Breast, Nanjing Maternity and Child Health Hospital of Nanjing Medical University, Nanjing, 210004, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D055088:Early Detection of Cancer; D004724:Endoscopy / Q000379:methods*; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate