Cost-benefit analysis of screening for esophageal and gastric cardiac cancer / 癌症

In 2005, a program named "Early Detection and Early Treatment of Esophageal and Cardiac Cancer" (EDETEC) was initiated in China. A total of 8279 residents aged 40-69 years old were recruited into the EDETEC program in Linzhou of Henan Province between 2005 and 2008. Howerer, the cost-benefit of the EDETEC program is not very clear yet. We conducted herein a cost-benefit analysis of screening for esophageal and cardiac cancer. The assessed costs of the EDETEC program included screening costs for each subject, as well as direct and indirect treatment costs for esophageal and cardiac severe dysplasia and cancer detected by screening. The assessed benefits of this program included the saved treatment costs, both direct and indirect, on esophageal and cardiac cancer, as well as the value of prolonged life due to screening, as determined by the human capital approach. The results showed the screening cost of finding esophageal and cardiac severe dysplasia or cancer ranged from RMB 2707 to RMB 4512, and the total cost on screening and treatment was RMB 13 115-14 920. The cost benefit was RMB 58 944-155 110 (the saved treatment cost, RMB 17 730, plus the value of prolonged life, RMB 41 214-137 380). The ratio of benefit-to-cost (BCR) was 3.95-11.83. Our results suggest that EDETEC has a high benefit-to-cost ratio in China and could be instituted into high risk areas of China.

Period survival analysis of esophageal cancer in Linzhou city of Henan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the survival level and variation of esophageal cancer in Linzhou city of Henan province from 1988 to 2004, and evaluate the effects of diagnosis and treatments on esophageal cancer in this area.</p><p><b>METHODS</b>All incidence and death records for esophageal cancer during 1988 to 2004 were collected from Linzhou Tumor Registry. Cases with duplicate information or death certificate only were excluded. A total of 12,160 cases of esophageal cancer were collected, of which, 6914 cases were male, and 5246 cases were female. The sex-specific and age-specific probabilities of survival in 1992, 1997 and 2002 were calculated and linked to the data of incidence and death on esophageal cancer in this area. Five-year observed survival rate and five-year relative survival rate during 1990 to 1994, 1995 to 1999, 2000 to 2004 were calculated respectively using period survival analysis and cohort survival analysis and Z test.</p><p><b>RESULTS</b>The 5-year relative survival rates among the three-episode were 28.24%, 35.24% and 40.76% respectively during 1988 to 2004. This showed an increasing trend by periods (Z values were 3.94 and 3.07, P < 0.05). The 5-year observed survival rates in men among the three-episode were 13.67%, 18.08% and 22.46% respectively, the 5-year relative survival rates were 29.94%, 36.96% and 38.40%. The 5-year observed survival rates in women among the three-episode were 15.56%, 19.29% and 28.01% respectively, the 5-year relative survival rates were 26.78%, 33.12% and 43.70%. During the two former periods, there was no significant difference in the 5-year observed survival rate and relative survival rate between men and women (Z values of observed survival rate were 1.48 and 0.88, P > 0.05. Z values of relative survival rate were 1.27 and 1.50, P > 0.05). In the third period, the 5-year observed survival rate and relative survival rate in women was higher than that in men (observed survival rate Z = 3.56, P < 0.05; relative survival rate Z = 2.09, P < 0.05). The relative survival rate that calculated using period method (respectively 35.24% and 40.76%) was higher than that using cohort method (respectively 28.77% and 33.35%) from 1995 to 1999, and from 2000 to 2004.</p><p><b>CONCLUSION</b>The survival rate on esophageal cancer in Linzhou city was increasing in the three different periods. This indicated a rising status in the secondary prevention and clinical diagnosis and treatments on esophageal cancer.</p>

The trends on the mortality for esophagus and stomach cancers in Linzhou city from 1988 to 2003 / 中华预防医学杂志

<p><b>OBJECTIVE</b>Using the data on death for esophagus and stomach cancers in Linzhou cancer registration system, the mortality was described as well as the changing trend was analyzed.</p><p><b>METHODS</b>18 240 death recorders for the both cancers during 1988 to 2003 were drawn from Linzhou cancer registration system. Of which, 10138 cases were esophageal cancer and 8102 cases were gastric cancer. Then data were stratified by sex, age, year and then linked to demographic classifications. The mortalities of two topographic site cancers were calculated and the age-adjusted rates were calculated by direct standardization to the world population. The Joinpoint model was used to get the estimated annual percent change (EAPC) of the age-adjusted rates, so to estimate the death rate change trends of both cancers in population of Linzhou city.</p><p><b>RESULTS</b>In 2003, the age-adjusted mortalities of esophageal cancer and gastric cancer were 68.47 per 100,000 and 57.01 per 100,000 respectively of Linzhou city. From 1988 to 2003 the death rates for both of cancers had showed the decline trends. The EAPC of the mortality for esophageal cancer was -3.82 (-4.81 - -2.82, P < 0.001) and that for gastric cancer was -2.95 (-4.16 - -1.73, P < 0.001) respectively.</p><p><b>CONCLUSION</b>The declining trend in was observed the mortality of esophageal and gastric cancer in Linzhou by this study.</p>