Screening for oesophageal cancer

Area of Science:

• Oncology
• Gastroenterology
• Preventive Medicine

Background:

• Esophageal cancer presents a significant global health challenge.
• Early-stage esophageal cancer is curable, improving survival rates.
• Screening methods like endoscopy with iodine staining and cytologic examination are used, but their efficacy is debated due to potential biases.

Purpose of the Study:

• To assess the effectiveness of early screening for esophageal cancer in reducing mortality among asymptomatic individuals.
• To evaluate screening using endoscopy with iodine staining or cytologic examination in high-risk and general populations.

Main Methods:

• A comprehensive literature search was conducted across multiple databases for randomized controlled trials (RCTs).
• Inclusion criteria focused solely on RCTs comparing screening versus no screening for esophageal cancer.
• Studies were screened by two independent reviewers.

Main Results:

• A total of 3482 studies were identified, with 18 retrieved for further review.
• No randomized controlled trials met the eligibility criteria for investigating the effects of screening versus no screening for esophageal cancer.
• The review found no RCTs determining the efficacy of esophageal cancer screening.

Conclusions:

• There is a lack of high-quality randomized controlled trials to confirm the efficacy of esophageal cancer screening.
• Observed survival benefits in non-RCTs may be influenced by selection bias and lead-time/length-time biases.
• Randomized controlled trials are essential to definitively determine the effectiveness of screening for esophageal cancer.