| Objective To systematically analyze the adherence to endoscopic screening among high-risk populations for upper gastrointestinal (UGI) cancer in China and provide evidence for developing targeted intervention strategies. Methods A systematic literature search was conducted in English databases (Web of Science, PubMed, and Embase) and Chinese databases (CNKI, Wanfang, and VIP) to identify studies reporting the compliance rates of upper gastrointestinal cancer endoscopic screening among Chinese populations. Subgroup analyses were performed considering differences in regions, age, gender, and screening programs. Additionally, sensitivity analysis and publication bias assessment were conducted. Results A total of 34 studies from 16 administrative regions, involving 766039 participants, were included. The overall compliance rate of endoscopic screening for upper gastrointestinal cancer among high-risk Chinese populations was 35.8% (95% CI: 31.0%-40.5%). Subgroup analyses revealed that the compliance rate was higher in rural areas (44.3%) compared to urban areas (32.5%) (P<0.05). The compliance rates were 37.9% for males and 43.0% for females (P>0.05). The age group 50-59 years showed a compliance rate of 41.6%, while the 40-49 years group showed 37.5% (P>0.05). The Cancer Early Detection and Treatment Project in the Huaihe River Basin demonstrated higher compliance rates than urban cancer screening programs (P<0.05). In rural areas, males showed lower compliance (41.7%) compared to females (49.4%) (P<0.05), with compliance rates increasing with age. In urban areas, the compliance rates were 38.9% for the 50-59 age group and 30.7% for the 60-74 age group, with no statistically significant differences (P>0.05). Sensitivity analysis, after excluding studies with smaller sample sizes, showed slight changes in the meta-analysis results. Conclusion The study revealed suboptimal compliance rates for endoscopic screening among high-risk populations for upper gastrointestinal cancer in China, with significant regional and gender disparities. These findings suggest the need for targeted interventions specifically designed for male populations and urban areas. Additionally, strengthening the capacity of screening service providers is essential to improve public awareness and screening participation rates. |
