TOPLINE:

A risk-based screening strategy shows high efficacy and significant reductions in cost in the detection of upper gastrointestinal cancers compared with conventional universal screening, results from a real-world study at two screening sites in China showed.

The screening protocol could provide important improvements upon conventional universal screening, which consumes considerable medical resources, with relatively low malignant upper gastrointestinal detection rates.

METHODOLOGY:

• Researchers enrolled 9492 participants in an ongoing screening project in two areas in China, Longde and Litong, and were assessed with the easy-to-use Upper Gastrointestinal Cancer Risk Assessment Service Platform.
• The screening tool uses cloud computing, embedded in a WeChat Mini Program to facilitate data collection and provide real-time feedback of assessment results.
• The tool provides risk scores for malignant gastric lesions (G-score) and malignant esophageal lesions (E-score) based on formulas assessing risk factors including age, gender, family history of gastric cancer, BMI, unexplained weight loss, food consumption leftover or preserved food, smoking, epigastric or retrosternal pain, and dysphagia.

TAKEAWAY:

• Of the participants, 2552 (26.8%) were determined to be high-risk, and of those individuals, 1198 (46.9%) received further endoscopic examination.
• The malignant cancer detection rate, overall, was 2.28 times higher than that reported in historical data through universal screening (P = .002) (Longde: 2.15% vs 0.99%; Litong: 1.18% vs 0.38%); and the early detection rate was approximately 60%-70%.
• The average cost for detecting one case was as much as 30.7% lower than that for universal screening (Longde: $12,919 vs $16,783; Litong: $21,836 vs $45,512); additionally, the cost for detecting one early cancer was 28.9% lower than that for universal screening (Longde: $20,993 vs $24,475; Litong: $30,570 vs $75,854).
• The number of residents reached through the epidemiological investigations was 6- to 8-times that of universal screening.

IN PRACTICE:

“This real-world, multi-center study demonstrates that the adoption of sequential screening by identifying high-risk individuals based on real-time risk assessment prior to endoscopic examinations is feasible and cost-effective in detecting upper gastrointestinal cancers,” the authors concluded.

SOURCE:

This study was conducted by senior authors Zhonghu He and Yang Ke, of the State Key Laboratory of Molecular Oncology, Beijing Key Laboratory of Carcinogenesis and Translational Research,

Department of Genetics, Peking University Cancer Hospital & Institute, in Beijing, China, and colleagues.

This study was published in the British Journal of Cancer.

LIMITATIONS:

• Due to the use of historical data as the comparison in this study, “parallel comparative studies are warranted,” the authors noted.
• In addition, the findings still require validation across diverse populations.

DISCLOSURES:

The authors had no disclosures to report.