| Between 2016 and 2025, the Cancer Screening Program in Huai River Areas of Jiangsu Province conducted 112,602 clinical screenings, comprising 86,950 initial examinations and 24,560 re?examinations. The annual screening coverage for upper gastrointestinal cancer (UGC) was 0.68% in 2016 and 0.32% in 2025, while that for liver cancer (LC) was 0.30% and 0.28%, respectively. Overall, the program achieved a detection rate of 0.81%, an early diagnosis rate of 72.61%, and a treatment rate of 92.63%. UGC exhibited higher detection (1.36%) and early diagnosis rates (73.26%) than LC (0.30% and 69.89%, respectively), whereas LC had a marginally higher treatment rate (96.02%) than UGC (91.81%). Over the decade, performance indicators among initial screening participants were more stable than those among re?examination participants. During the same period, the incidence and mortality of UGC in the population aged 40–74 years in the project areas declined by an average of 5.7% and 5.3% per year, respectively; for LC in those aged 35–74 years, the corresponding annual reductions were 4.7% and 4.2%. Significant decreases were observed in all age groups except for UGC at 40–44 years and LC at 35–39 years. Economic evaluation using the early detection cost index (EDCI) showed that, under central government funding alone, the EDCI for UGC and LC fell from 0.64 and 3.36 in 2016 to 0.41 and 2.42 in 2025, respectively, suggesting improved cost?effectiveness alongside economic growth. When non?central government funds matched central funds at a 1:1 ratio, the EDCI for LC approached 5 (4.84); even with a 3:1 match, the EDCI for UGC remained well below 5 (1.63). Overall, the program demonstrated stable screening performance, high treatment adherence, and a concurrent significant decline in target cancer burden in the project areas, indicating that long?term, systematic early diagnosis and treatment strategies are feasible and potentially cost?effective in this region. Nevertheless, its independent contribution to the overall population disease burden warrants further investigation. |
