| Abstract: [Objective] To analyze the impact of timeliness of treatment on survival outcomes of positive patients with upper gastrointestinal cancer screening and to explore the optimal interval between screening to treatment. [Methods] This study was based on the population-based upper gastrointestinal cancer screening cohort in Feicheng City, Shandong Province. Patients who underwent endoscopic screening between January 2014 and December 2015 and were diagnosed as screening-positive (high-grade intraepithelial neoplasia or early-stage cancer) were included in the study. Ten-year survival outcome data with positive patients were obtained through the cancer registry and death registry. Based on the interval between screening positivity and initiation of treatment, screening-positive individuals were classified into a timely treatment group (≤30 days) and a delayed treatment group (>30 days), using 30 days as the cutoff. The Kaplan–Meier method was used to estimate the 10-year survival rate among screening-positive individuals, and multivariable Cox proportional hazards regression model was applied to evaluate the association between treatment timeliness and the risk of death. [Results] A total of 267 positive patients were included, with a mean age of 70.7(SD,6.1). The overall 10-year survival rate was 79.6% (95% CI: 74.8%–84.6%), with the timely treatment group showing the highest survival rate at 94.4% (95% CI: 89.2%–99.9%). When the delayed treatment interval was further categorized into 60 days, 90 days, and >90 days, With the treatment interval increased, a clear decreasing trend in 10-year survival was observed among positive patients. Further analysis of influencing factors showed that screening-positive individuals who were older, BMI > 24 kg/m2, and received surgical treatment were more likely to undergo timely diagnosis and treatment (P < 0.05). [Conclusions] Timely treatment plays a critical role in improving the prognosis of positive patients. Comprehensive management of the entire screening-to-treatment process should be strengthened, establishing a closed-loop system of “early screening–early treatment” to maximize long-term survival and health benefits for positive patients, while ensuring efficient utilization of medical resources. |
