A prospective study of esophageal cytological atypia in Linxian county

Between 1975 and 1986, in Linxian county (LX), a prospective study of esophageal cytological hyperplasia and atypia was conducted on 3 groups of subjects: 294 with marked atypia, 328 with mild hyperplasia and 336 normal controls; all were diagnosed by cytology. Results showed that no significant difference in incidence of esophageal cancer (EC) appeared between subjects with mild hyperplasia and controls, while the incidence of EC in subjects with marked atypia was 1,178.92/100,000 which was 2.39 (after age-adjustment 2.90) times higher than that found in the control group and was of statistical significance (chi 2 = 8.92, p less than 0.01). In all groups, the relatively high risk of contracting EC was closely associated with drinking ground water, smoking and a low standard of living. These results suggest that early treatment should be given to subjects with marked atypia, accompanied by preventive measures against carcinoma of the esophagus, such as hygienic drinking water, abstention from smoking and better living conditions.