title: Effectiveness of endoscopic gastric cancer screening in a rural area of Linzhou, China: results from a case-control study.
abstract: In China, a large burden of gastric cancer has remained, and endoscopic screening was expected to reduce gastric cancer mortality. Therefore, a population-based case-control study was conducted to evaluate the screening effect. The gastric cancer screening program was initiated in Linzhou in the year 2005, and endoscopic examination with indicative biopsy, for residents aged 40-69 years, was used to detect early cancer and precancerous lesion. In this study, cases were defined as individuals who had died of gastric cancer, which were selected from Linzhou Cancer Registry database. Controls were residents (six per case), who had not died of gastric cancer, from the same area as the case, and matched by gender and age (±2 years). The exposure status, whether cases and controls ever attended the screening or not, was acquired by inspecting the well-documented screening records. Conditional logistic regression model was used to estimate the odds ratios (OR) and their 95% confidence intervals (95% CI). A total of 313 cases and 1876 controls were included in our analysis. Compared with subjects who never participated in screening, the overall OR for individuals who ever participated in screening was 0.72(95% CI: 0.54-0.97). The OR for lag time 4 years or longer was 0.68(95% CI: 0.47-0.98) and the OR for those who were aged 50-59 years were 0.56 (0.37-0.85). The results suggest a 28% reduction in risk of gastric cancer mortality by endoscopic screening, which may have significant implications for gastric cancer screening in rural areas of China.
authors.affiliation: Department of Cancer Epidemiology, Henan Cancer Hospital/Institute, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Linzhou Cancer Registry, Linzhou Cancer Hospital, Linzhou, 456500, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Yu
authors.affiliation: Linzhou Cancer Registry, Linzhou Cancer Hospital, Linzhou, 456500, China.
authors.forename: Chang-Qing
authors.initials: CQ
authors.lastname: Hao
authors.affiliation: Linzhou Cancer Registry, Linzhou Cancer Hospital, Linzhou, 456500, China.
authors.forename: Jin-Wu
authors.initials: JW
authors.lastname: Wang
authors.affiliation: Department of Cancer Epidemiology, Henan Cancer Hospital/Institute, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China.
authors.forename: Shu-Zheng
authors.initials: SZ
authors.lastname: Liu
authors.affiliation: Department of Cancer Epidemiology, Henan Cancer Hospital/Institute, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Cancer Epidemiology, Henan Cancer Hospital/Institute, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China.
authors.forename: Shao-Kai
authors.initials: SK
authors.lastname: Zhang
authors.affiliation: Department of Cancer Epidemiology, Henan Cancer Hospital/Institute, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China.
authors.forename: Lan-Wei
authors.initials: LW
authors.lastname: Guo
authors.affiliation: Department of Cancer Epidemiology, Henan Cancer Hospital/Institute, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China.
authors.forename: Pei-Liang
authors.initials: PL
authors.lastname: Quan
authors.affiliation: Department of Environmental Health Sciences, Yale University School of Public Health, 60 College Street, LEPH 440, New Haven, Connecticut, 06520.
authors.forename: Nan
authors.initials: N
authors.lastname: Zhao
authors.affiliation: Department of Environmental Health Sciences, Yale University School of Public Health, 60 College Street, LEPH 440, New Haven, Connecticut, 06520.
authors.forename: Ya-Wei
authors.initials: YW
authors.lastname: Zhang
authors.affiliation: Department of Cancer Epidemiology, Henan Cancer Hospital/Institute, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China. xbsun21@sina.com.
authors.forename: Xi-Bin
authors.initials: XB
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D055088:Early Detection of Cancer; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011159:Population Surveillance; D012042:Registries; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*
keywords: Case-control study; effectiveness; gastric cancer; screening program