Prospective Cohort Study Of The Effect Of Endoscopic Screening In TNM Stage Of Esophageal Cancer Patients

Qing MA, Cancer Institute/Hospital, Chinese Academy of Medical Sciences, China
SONG G. 2 , FENG H. 1 , MA S. 1 , LI X. 1 , WEI W. 1

1 Department of Cancer Epidemiology, Cancer Institute / Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing,China.
2 Cixian Institute for Cancer Prevention and Control,Cixian,China

Purpose:To investigate whether an endoscopic screening and intervention program could make patients to be diagnosed in earlier TNM stage.
Methods:This study was on the basis of a preliminary study from January 1,2000 to December 31,2009, which selected fourteen villages as the intervention communities and ten villages not geographically adjacent to intervention villages for comparison. Participants in the intervention group were screened once by endoscopy with Lugol’s iodine staining, and those with dysplasia or occult cancer were treated. A retrospective analysis was performed on the clinical data of 168 patients with esophageal cancer, which come from the intervention group and control group. The c2 test was used to analysis the difference of TNM stage between two groups, the Kaplan-Meier curve compared survival rate of patients in two groups, the risk factors of death in patients of two groups were analyzed through Cox regression analysis.
Results:We collected 168 case reports in Cixian cancer hospital and Cixian county people’s hospital range from 2000 to 2013, among them 166 case reports had detailed information to estimate their TNM stage, which contained 78 cases from the intervention group and 88 cases from the control group. There was significant difference of the TNM stage between intervention group and control group.Survival analysis using Kaplan-Meier methods showed that the 1-year survival rates and 5-year survival rates in intervention group and control group were 65.0%,60.3% and 10.0%,6.3% respectively, with significant differences (P=0.042) between the survival curves of two groups. The multivariate analysis showed that intervention measure was the independent prognostic factor.  
Conclusions:We showed that endoscopic screening and intervention significantly made esophageal cancer patients to be diagnosed in earlier TNM stage. And this can be the medium-term indicator for evaluating the effectiveness of screening.
Funding source:National Natural Science Foundation of China