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Stage-Specific Survival From Esophageal Cancer in China and Implications for Control Strategies: A Systematic Review and Meta-Analyses.
He, Yu; Quaresma, Manuela; Dos-Santos-Silva, Isabel.
Afiliación
  • He Y; Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
  • Quaresma M; Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
  • Dos-Santos-Silva I; Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Gastro Hep Adv ; 2(3): 426-437, 2023.
Article en En | MEDLINE | ID: mdl-39132661
ABSTRACT
Background and

Aims:

Esophageal cancer claims more than 500,000 deaths worldwide, with half occurring in China. We aimed to synthesize existing evidence on stage-specific survival from this cancer in China to inform cancer control strategies.

Methods:

English and Chinese literature databases were systematically searched to identify original research published up to May 31, 2019 that reported stage-specific survival from esophageal cancer in China. Two meta-analyses were performed using random-effects models to summarize stage-specific survival differences on relative and absolute scales. The number of esophageal cancer deaths that might have been prevented by early detection in China, in 2018, was estimated assuming 2 different downstaging scenarios.

Results:

One hundred fifty eligible studies were identified, 97 had non-overlapping study populations (83,063 participants), 47 were included in the meta-analysis of hazard ratios, and 26 in the meta-analysis of survival probabilities. Late-stage (III-IV) was associated with 92% higher hazard of death compared with early-stage (0-II) (95% confidence interval 1.62-2.28), corresponding to an absolute 5-year survival difference of 31.2% (29.9%-32.4%). In all, 5.2% esophageal cancer deaths could have been prevented in China, in 2018, if the observed stage distribution at diagnosis (∼50% early-stage) was shifted to the real-life conditions of a population-based endoscopic screening program (∼60% early-stage) and 26.9% if shifted to that observed in the controlled setting of a randomized trial (∼90% early-stage).

Conclusion:

Shifting downwards the stage distribution of esophageal cancer through screening would bring moderate reductions in mortality from the disease. Treatment improvements for early-stage patients are needed to reduce further mortality from this cancer.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Gastro Hep Adv Año: 2023 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Gastro Hep Adv Año: 2023 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Países Bajos