An initial screening strategy based on epidemiologic information in esophageal cancer screening: a prospective evaluation in a community-based cancer screening cohort in rural China.

BACKGROUND AND AIMS: In China, regional organized esophageal cancer screening programs have been implemented since 2005. However, the implementation of these screening programs is still facing some urgent challenges, especially concerning identifying high-risk individuals. This study aimed to evaluate the risk stratification potential of the current initial assessment strategy used in a mass esophageal squamous cell carcinoma (ESCC) screening program in China. METHODS: A total of 43,875 participants without a previous cancer history enrolled in a mass ESCC screening program in China from 2007 to 2010 who had initial assessment results were included in this study and were followed until December 31, 2015. Eight potential risk factors for ESCC were evaluated in the initial assessment strategy. A comprehensive evaluation of the association of the initial assessment results with ESCC risk was performed by propensity score matching and Cox regression analysis. RESULTS: During a median follow-up of 5.5 years, 272 individuals developed ESCC. The high-risk population assessed at baseline had a higher risk of ESCC than the non-high-risk population, with a hazard ratio (HR) of 3.11 (95% confidence interval (CI), 2.33-4.14) after adjustment for sex, age, education level, income level, and body mass index. In addition, the initial assessment results of the high-risk population were significantly associated with the risk of all esophageal cancers (HR, 3.30; 95% CI, 2.51-4.33) and upper gastrointestinal cancers (HR, 3.03; 95% CI, 2.43-3.76). CONCLUSIONS: The initial screening tool in a mass ESCC screening program in China, consisting of 8 accessible variables in epidemiologic surveys, could be helpful for the selection of asymptomatic individuals for priority ESCC screening.

[Technical measures of filariasis elimination in Tengzhou City].

OBJECTIVE: To summarize the technical measures in achieving the elimination of lymphatic filariasis in Tengzhou city. METHODS: To collect and analyze the materials on research and control of lymphatic filariasis in Tengzhou city during the disease elimination program over the 40 years. RESULTS: Following to the national criteria for the control and elimination of filariasis, efforts were made for epidemiological investigation, mass blood examination, and mass drug administration by taking diethylcarbamazine (DEC) medicated salt for the whole population. After the criteria of transmission interruption (basic elimination) of filariasis were met in 1974, re-examination and treatment for the cases with microfilaremia, and parasitological and entomological surveillance were conducted. In 1995, filariasis elimination in the whole city was declared. CONCLUSION: Comprehensive measures focusing on the elimination of source of infection were proved effective for interrupting the transmission of filariasis. Unremitting surveillance was necessary for achieving the goal of elimination of filariasis.