| [Objective] To analyze the cancer high-risk assessment and follow-up results of the urban cancer early detection and treatment project population in Guangxi Zhuang Autonomous Region from 2014 to 2022, providing a basis for evaluating the implementation effect of regional projects and cancer early detection and treatment strategies. [Methods] From November 2014 to December 2022, according to the "Technical Plan for the Urban Cancer Early Detection and Treatment Project," a cancer risk factor questionnaire survey on risk factors and assessments of high-risk populations for five major types of cancer (lung cancer, colorectal cancer, upper gastrointestinal cancer, breast cancer, and liver cancer) were conducted among urban residents aged 40 to 74 in Nanning, Wuzhou, and Liuzhou, Guangxi. Active and passive follow-ups were conducted on the cohort population, matched with local tumor registration databases and population-wide cause-of-death surveillance databases. The follow-up period ended in March 2024, obtaining incidence information on the above five types of cancer among the cohort population.. Stratification was performed based on age, gender, assessment year, and at least one or single high-risk factor, and the high-risk rates and incidence of the five major high-incidence cancers among various characteristics of the cohort were compared. [Results] A total of 200,583 people completed the cancer risk questionnaire assessment, with the majority aged 40 to 49, accounting for 33.50%; females accounted for 56.67%; the high-risk rate for at least one cancer type was 71.31%, with the highest single high-risk rate being female breast cancer (33.21%), followed by lung cancer (25.48%), and liver cancer (23.97%); there were significant differences in high-risk rates among different genders, age groups, and assessment years (all P < 0.001). A total of 1,310,805.40 person-years were followed up, with an average follow-up of (6.54 ± 2.18) years, and 2,634 cases of confirmed cancer were identified, with a cumulative incidence rate of 1,313.17/100,000 and an incidence density of 200.95/100,000 person-years. The risk of developing the five cancers was higher in males than in females, with a hazard ratio (HR) (95% confidence interval [CI]) of 1.113 (1.018–1.217); compared to the 40–49-year-old group, the HR (95% CI) was 3.581 (2.998–4.278) in the 70–74-year-old group; the risk of developing cancer was higher in individuals with at least one high-risk factor for cancer than in those without, with an HR (95% CI) of 1.154 (1.041–1.278); compared to non-high-risk individuals with the same cancer type, the risk of developing breast cancer, colorectal cancer, and lung cancer was 1.930 (1.564–2.381) times, 1.296 (1.062–1.582) times, and 1.285 (1.100–1.502) times higher, respectively; there was no significant difference in the risk of developing cancer between high-risk individuals with single liver cancer, gastric cancer, and esophageal cancer compared to non-high-risk individuals with the same cancer type. [Conclusion] The cancer high-risk assessment model of the urban cancer early detection and treatment project has predictive value for the incidence of high-risk individualsshowed varying predictive values for identifying high-risk populations of different cancer types in this region, and the project assessment scheme can could be further optimized by incorporating biomarker detection to further concentrate high-risk individuals. |
