Stage-Specific Survival From Esophageal Cancer in China and Implications for Control Strategies: A Systematic Review and Meta-Analyses.

Yu He ; Manuela Quaresma ORCID logo ; Isabel Dos-Santos-Silva ORCID logo ; (2022) Stage-Specific Survival From Esophageal Cancer in China and Implications for Control Strategies: A Systematic Review and Meta-Analyses. Gastro Hep Advances, 2 (3). pp. 426-437. ISSN 2772-5723 DOI: 10.1016/j.gastha.2022.10.012
Copy

BACKGROUND AND AIMS: Esophageal cancer claims more than 500,000 deaths worldwide, with half occurring in China. We aimed to synthesize existing evidence on stage-specific survival from this cancer in China to inform cancer control strategies. METHODS: English and Chinese literature databases were systematically searched to identify original research published up to May 31, 2019 that reported stage-specific survival from esophageal cancer in China. Two meta-analyses were performed using random-effects models to summarize stage-specific survival differences on relative and absolute scales. The number of esophageal cancer deaths that might have been prevented by early detection in China, in 2018, was estimated assuming 2 different downstaging scenarios. RESULTS: One hundred fifty eligible studies were identified, 97 had non-overlapping study populations (83,063 participants), 47 were included in the meta-analysis of hazard ratios, and 26 in the meta-analysis of survival probabilities. Late-stage (III-IV) was associated with 92% higher hazard of death compared with early-stage (0-II) (95% confidence interval 1.62-2.28), corresponding to an absolute 5-year survival difference of 31.2% (29.9%-32.4%). In all, 5.2% esophageal cancer deaths could have been prevented in China, in 2018, if the observed stage distribution at diagnosis (∼50% early-stage) was shifted to the real-life conditions of a population-based endoscopic screening program (∼60% early-stage) and 26.9% if shifted to that observed in the controlled setting of a randomized trial (∼90% early-stage). CONCLUSION: Shifting downwards the stage distribution of esophageal cancer through screening would bring moderate reductions in mortality from the disease. Treatment improvements for early-stage patients are needed to reduce further mortality from this cancer.


picture_as_pdf
Quaresma-etal-2023-Stage-Specific-Survival-From-Esophageal-Cancer-in-China-and-Implications-for-Control-Strategies-A-Systematic-Review-and-Meta-Analyses.pdf
subject
Published Version
Available under Creative Commons: Attribution-NonCommercial-No Derivative Works 4.0

View Download

Atom BibTeX OpenURL ContextObject in Span Multiline CSV OpenURL ContextObject Dublin Core Dublin Core MPEG-21 DIDL Data Cite XML EndNote HTML Citation JSON MARC (ASCII) MARC (ISO 2709) METS MODS RDF+N3 RDF+N-Triples RDF+XML RIOXX2 XML Reference Manager Refer Simple Metadata ASCII Citation EP3 XML
Export

Downloads