| Abstract: [Purpose] To analyze the screening and prevention and control effect of upper gastrointestinal cancer in Yandu District of Yancheng City from 2013 to 2024. [Methods] The screening data of the Huaihe River Basin Upper Gastrointestinal Cancer Early Diagnosis and Treatment Project, the data of the regional cancer registration system and the management data of the permanent population in the jurisdiction from 2013 to 2024 were integrated to calculate the high-risk rate, compliance rate, detection rate and early diagnosis rate. The joinpoint regression model was used to calculate the average annual percentage change (AAPC), and the trends of detection rate and early diagnosis rate were analyzed. Kaplan-Meier method was used to draw the survival curve, and Cox proportional hazard regression model was constructed to analyze the influencing factors of overall survival ( OS ). [Results] A total of 64 047 subjects were included in the screening. The high-risk rate of upper gastrointestinal cancer was 49.10%, and the compliance rate of gastroscopy was 62.42%. There were statistically significant differences in the high-risk rate and compliance rate among people with different characteristics (P<0.001). The overall detection rate was 0.92%, showing an upward trend (AAPC=7.35%,P=0.031). The overall early diagnosis rate was 58.56%, with no significant change trend (AAPC=-2.39%,P=0.430). The detection rates of gastric cancer and esophageal cancer were higher in males than in females and increased with age (P<0.001), and there was no significant difference in early diagnosis rate (P>0.05).During the follow-up period, 825 cases of progression and 353 deaths were detected. The risk of death in women was lower than that in men (HR=0.37,95%CI:0.29-0.47). The risk of death in people aged ≥ 60 years was higher than that in people aged 40-49 years (HR=3.74,95%CI:2.82-4.98). The risk of death in high-risk groups was higher than that in non-high-risk groups (HR=1.29,95%CI:1.04-1.60). [Conclusion] The high-risk rate and compliance rate of upper gastrointestinal cancer screening in Yandu District are at the upper-middle level inside and outside the province. The detection rate and early diagnosis rate are generally stable, but there is still room for improvement. It is suggested that the whole process of screening and health management should be optimized for male and elderly people, and the comprehensive prevention and control efficiency of early cancer should be strengthened based on the medical prevention integration system, so as to further reduce the disease burden of upper gastrointestinal cancer in the region. |
