High incidence of cardiac esophageal and gastric cancer epidemic and its impact on endoscopic screening strength analysis of the Enlightenment
【Abstract】 Objective To analyze the Shexian high incidence of cardiac and other esophageal and gastric cancer epidemic
intensity, sharpening their combat missions, explore the specific control approach. A Comparative Analysis Shexian, Lin County, Cixian the whole population registered with esophageal cancer, cardia cancer, gastric cancer incidence and mortality
rates, and endoscopic screening of 6233 patients involving 40 to 69-year-old crowd three kinds of cancer and precancerous lesions of the review output rate. Results southern foot of Taihang Mountain high incidence of esophageal cancer
esophageal and gastric cardia cancer incidence or mortality in the total systemic malignant tumors accounted for 70% ~ 80%. Shexian from 2000 to 2004 the incidence of cardia of both sexes were 69.9/10 and 41.5/10 10000 10000, the mortality rate for males and females were 54.3 / 10 million and 33.2/10 million. High incidence of iodine staining to guide the use of endoscopic biopsy screening for squamous cell esophageal precancerous lesions and early cancer detection rate, but the cardia, and gastric epithelial precancerous lesions and early
cancer detection rate is relatively low. Conclusion southern Taihang Mountains there is high incidence of esophageal cancer and gastric cardia common phenomenon of high incidence, in order to rule by early diagnosis and early reduction in the
region from the whole upper digestive tract cancer mortality, the need to strengthen endoscopy and gastric cardia epithelial precancerous lesions and early cancer detection research.
Key words high incidence of esophageal endoscopy screening
for precancerous lesions of gastric cardia cancer
China's High-Risk Area for esophageal cancer prevention and control efforts have been half a century has made great achievements, the current hot spots focused on the use of
prevention and treatment of iodine staining of endoscopic biopsy guidance technologies for high-risk populations for
screening, early diagnosis and treatment of precancerous lesions and early esophageal cancer cancer, in order to reduce the mortality rate of esophageal cancer . We are screening the scene in recent years, found that endoscopic iodine staining technique to guide biopsy of early esophageal squamous cell carcinoma and precancerous lesions has a good detection capability, but right cardia, and gastric epithelial
cancer and early detection of precancerous lesions is still is not ideal. Also due to historical reasons, the last High Risk Area Cancer Registry often classified as esophageal cardia has long been the lack of cardiac morbidity or mortality related
to the actual reported , cardia, and gastric epithelial cancer at the end of numerous and can not The detection rate on the level of screening to make reasonable judgments. In view of this, we Shexian population-wide cancer registration
of the cardia cancer types as a separate register now statistics from 2000 to 2004 morbidity and mortality data, and with neighboring counties and Cixian data on forest comparison, the purpose is to analyze high incidence of esophageal and gastric cardia share further clarify the
cardia, and gastric epithelial cancer prevention and control task, to find a new research direction.
1.1 Shexian Information
Shexian is located in the southwestern tip of Hebei Province, is located at the junction of three provinces of the southern foot of Taihang Mountains, south of Henan Province Linzhou (Linxian), East Cixian by Hebei Province, Shanxi Province, bordering the West with a total population of 383,284, of which male 198,958 people, 184,326 were women.
County-wide cancer incidence and cause of death registration operation since 1996, methods for the county, township and village level by level monthly cancer doctors reported incidence of malignant tumor area and all-cause death card,
county cancer registries on a monthly basis from the hand Agatanoatae all hospitals to collect cancer incidence and cause of death fill the whole card, the last county tumor registry verification, tick weight, meta-analysis.
March 2001 ~ May 2005, we Shexian guided biopsy
endoscopic iodine staining method of screening for the village as a unit 40 to 69-year-old population 1514 cases, screening rate of 70% or more.
1.2 Linxian, Cixian information
Linxian, Cixian esophagus, cardia, gastric cancer
incidence and mortality is taken from the National Cancer Research Office edited the "Chinese pilot city and county cancer incidence and mortality," 1988 ~ 1992, 1993 and 1997 vols [3, 4]. Endoscopic screening data from two counties in [5,6].
2.1 Shexian cardiac morbidity and mortality in
As shown in Table 1 ~ 4, Shexian from 2000 to 2004 the incidence of cardia of both sexes were 69.9/10 and 41.5/10 10000 10000, the mortality rate for males and females were 54.3/10 and 33.2/10 10000 10000, and its body malignant tumors in the ranking, whether morbidity or mortality, according to both men and women after esophageal and gastric cancer, came in third place. This is by far the high incidence of esophageal cardiac morbidity and mortality, the first time.
2.2 esophagus, cardia, gastric cancer incidence and mortality levels of the comparison table 1 Shexian, Lin County, Cixian male esophageal cancer, Ben Table 2 Shexian, Lin County, Cixian female esophageal cancer, Ben Table 3
Shexian , Lin County, Cixian male esophageal cancer, Ben Table 4 Shexian, Lin County, Cixian female esophageal cancer, Ben
As shown in Table 1 ~ 4, Shexian from 2000 to 2004 the incidence of esophageal cancer in males and females respectively, 97.2/10 and 51.8/10 10000 10000, gastric cancer incidence rates were 90.9/10 and 44.8/10 10000 10000, esophageal cancer slightly higher than the stomach, cardia and
gastric cancer, but if the merger is far more than the incidence of esophageal cancer. Shexian male morbidity and
mortality of cardiac cancer are the equivalent of about 70% of esophageal cancer, female cardiac morbidity or mortality is equivalent to about 80% of esophageal cancer.
Linxian is not listed separately in the cardia cancer cases, from 1988 to 1992 and 1993 to 1997 the incidence of esophageal cancer in men, respectively, 92.7/10 and 81.2/10 10000 10000, gastric cancer incidence rates were 91.5/10 10000 and 82.4/10 million, the incidence of esophageal and gastric cancer is almost the same; but women slightly less than the incidence of gastric esophageal cancer.
It is worth noting that: Shexian and Linxian 1993 to 1997, whether or gastric cardia cancer incidence and mortality in a single gastric cancer were higher than the high incidence
of gastric cancer in Shandong Linqu the same period (including cardia) of morbidity and mortality (Linqu County from 1993 to 1997 the incidence of gastric cancer for males and females were 60.3/10 and 27.3/10 10000 10000, the death rate for males
and females were 41.4/10 and 18.2/10 10000 10000), indicating that Shexian and Linxian as a high incidence of esophageal cancer there is high incidence of gastric cardia cancer and the phenomenon. Reposted elsewhere in the paper for free download http://
2.3 Shexian, Lin County, Cixian three kinds of cancer and precancerous lesion detection rate of endoscopic screening in Table 5 Shexian, Lin County, Cixian 40 ~ 69-year-old residents
of endoscopic screening for esophageal and cardia, stomach and
the detection rate of precancerous lesions, such as shown in table 5: Shexian, Lin County, Cixian Endoscopic iodine staining and biopsy of the Methods 40 to 69-year-old
population screening for esophageal squamous epithelium can be detected from 2.1% ~ 2.7% of the carcinoma in situ, 1.1% ~
6.6% of severe dysplasia, and 8% of the mild and moderate dysplasia. But the comparison, endoscopy and gastric cardia adenocarcinoma within the epithelial mucosa and precancerous lesions of the detection capability is very low, in order to
cardia example: Shexian and Linxian Mallory detection rate of adenocarcinoma in only 0.6% and 0.7%, and their respective counties the proportion of esophageal carcinoma in situ detection rate of about 1:4 (Cixian Mallory lower detection
rate of carcinoma in situ, only 0.1%, may be related to mucosal carcinoma in situ to determine standards for obtaining more strict relevant); severe dysplasia detection rates in the cardiac glandular epithelium and esophageal squamous epithelium the ratio between the Shexian and Cixian also about 1:4; with mild to moderate dysplasia detection rate is far lower than the esophageal cardia . Taking into account the registration of men cardia cancer incidence or mortality is equivalent to about 70% of esophageal cancer, female cardiac
morbidity or mortality is equivalent to about 80% of esophageal cancer, gastric cancer morbidity and mortality in patients with esophageal cancer compared with the Shexian and Lin County is almost the same, but the endoscopy and the
gastric epithelium of the gastric cardia precancerous lesions and early cancer detection rates with such a low incidence rate and registration does not match the level of mortality, prompt us to endoscopy cardia and gastric cancer and precancerous lesions of early detection of the ability to be improved.
3.1 strengthen the high incidence of upper digestive tract cancer, esophageal cancer focus on awareness of high
Past, because of esophageal and cardiac carcinoma in the
surgical treatment of the similarity of high incidence of cardiac tumors classified as esophageal cancer at the time of registration, resulting in high incidence of esophageal cancer in people the impression that the neglect of the cardia and stomach cancer awareness. Past two decades with the widespread application of endoscopy in the high incidence of upper digestive tract cancer occurrence has also been part of a clear positioning of the primary tumor site registration gradually become evidence-based, recognizing the southern foot
of the Taihang Mountains The so-called high incidence of
esophageal cancer is actually a concentration of high incidence of upper digestive tract cancer, not only high incidence of esophageal cancer, cardiac and gastric cancer is
also high, which combined three kinds of cancer incidence or mortality rates are both accounted for the body of all malignant cancer incidence or mortality of 70% to 80%, see Table 1 ~ 4, suggesting that this aspect of the environment or people's eating habits have a strong presence in the upper
digestive tract cancer-causing factors, these cancer-causing
factors, the long-term acting on the upper gastrointestinal mucosa, by some similar mechanism, not only led to a high incidence of esophageal cancer, but also led to high incidence
of cardia cancer and gastric cancer. On the other hand reminds us that the southern Taihang Mountains high incidence of esophageal cancer is actually a concentration of high incidence of upper digestive tract cancer, with the incidence
of esophageal squamous cell carcinoma is declining, and gastric cardia epithelial cancers will become increasingly prominent, it in recent years has aroused the concern of many scholars at home and abroad 〔7〕.
3.2 The high incidence of squamous cell esophageal
precancerous lesions and early cancer detection rate, but the cardia, and gastric epithelial precancerous lesions and early cancer detection rate is relatively low
Endoscopic esophageal mucosal iodine staining clearly indicated that the naked eye can not easily identify the lesions, but also contribute to biopsy accurate positioning, since the screening has been applied to the site has been proven to be effective in the early detection of a constant ratio of weight to cancer and atypical hyperplasia lesions,
sensitivity was 91% ~ 100%, a specificity of 40% to 95% , is Early Detection and Treatment of esophageal cancer has played a substantive contribution. However, endoscopy and gastric cardia adeno-epithelial staining but lack of effective
methods, coupled with cardia affected by respiratory activity, observation and biopsy is not easy, and the detection more difficult, the positive rate of endoscopic detection of gastric cardia cancer and the actual incidence of rate and mortality levels do not match, limiting the high incidence of early diagnosis and early governance of the overall effect, so there is an urgent need to strengthen the endoscopic detection of precancerous lesions of the glandular epithelium research.
This article first published the high incidence of esophageal cancer in southern Taihang Mountains Shexian cardiac morbidity and mortality data, in order to understand the prevalence of cardiac levels in the region provides the basis for the information. In addition this paper, an early
cancer and precancerous lesions with endoscopic detection rate of the registered population morbidity and mortality rates to
evaluate the endoscopy esophagus, cardia, stomach change detection capabilities, more than simply a more advanced
cancer detection rate of convincing, the results are more reliable.
In short, there is high incidence of cardiac Shexian such as esophageal and gastric cancer, the phenomenon of high incidence, in order to reduce the overall high incidence of
upper digestive tract cancer incidence and mortality, cardiac and gastric cancer must be given sufficient attention. At present, because endoscopy and gastric cardia epithelia of early detection of cancer and precancerous lesions of esophageal squamous intraepithelial lesions is far less satisfactory, no doubt limit the high incidence of early diagnosis and early administration of its overall effectiveness. Taking into account the high incidence of gastric cardia cancer and the proportion of larger, but also a
rising trend year by year cancer , so how best to early detection of precancerous lesions of glandular epithelium means to enhance the cardiac and gastric cancer prevention and treatment of The study will be a high incidence of upper digestive tract cancer, control of bottleneck.
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