%0 Journal Article
%@ 2369-2960
%I JMIR Publications
%V 9
%N 
%P e45360
%T Profiles and Findings of Population-Based Esophageal Cancer Screening With Endoscopy in China: Systematic Review and Meta-analysis
%A Li,He
%A Teng,Yi
%A Yan,Xinxin
%A Cao,Maomao
%A Yang,Fan
%A He,Siyi
%A Zhang,Shaoli
%A Li,Qianru
%A Xia,Changfa
%A Li,Kai
%A Chen,Wanqing
%+ Office of Cancer Screening, National Cancer Center of China/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 17 Panjia-yuan South Lane, Chaoyang District, Beijing, 100021, China, 86 13241914190, chenwq@cicams.ac.cn
%K esophageal cancer
%K screening
%K high-risk individuals
%K detection rates
%K China
%D 2023
%7 1.6.2023
%9 Review
%J JMIR Public Health Surveill
%G English
%X Background: Population-based esophageal cancer (EC) screening trials and programs have been conducted in China for decades; however, screening strategies have been adopted in different regions and screening profiles are unclear. Objective: We performed a meta-analysis to profile EC screening in China by positivity rate, compliance rate, and endoscopy findings, aiming to provide explicit evidence and recommendations for EC screening programs. Methods: English (PubMed, Embase) and Chinese (China National Knowledge Infrastructure, Wanfang) language databases were systematically searched for population-based EC screening studies in the Chinese population until December 31, 2022. A meta-analysis was performed by standard methodology using a random-effects model. Pooled prevalence rates were calculated for three groups: high-risk areas with a universal endoscopy strategy, rural China with a risk-stratified endoscopic screening (RSES) strategy, and urban China with an RSES strategy. Positive cases included lesions of severe dysplasia, carcinoma in situ, intramucosal carcinoma, submucosal carcinoma, and invasive carcinoma. Results: The pooled positivity rate of the high-risk population was higher in rural China (44.12%) than in urban China (23.11%). The compliance rate of endoscopic examinations was the highest in rural China (52.40%), followed by high-risk areas (50.11%), and was the lowest in urban China (23.67%). The pooled detection rate of positive cases decreased from 1.03% (95% CI 0.82%-1.30%) in high-risk areas to 0.48% (95% CI 0.25%-0.93%) in rural China and 0.12% (95% CI 0.07%-0.21%) in urban China. The pooled detection rate of low-grade intraepithelial neoplasia (LGIN) was also in the same order, being the highest in high-risk areas (3.99%, 95% CI 2.78%-5.69%), followed by rural China (2.55%, 95% CI 1.03%-6.19%) and urban China (0.34%, 95% CI 0.14%-0.81%). Higher detection rates of positive cases and LGIN were observed among males than among females and at older ages. The pooled early detection rate was 81.90% (95% CI 75.58%-86.88%), which was similar to the rates in high-risk areas (82.09%), in rural China (80.76%), and in urban China (80.08%). Conclusions: Under the current screening framework, a higher screening benefit was observed in high-risk areas than in other regions. To promote EC screening and reduce the current inequality of screening in China, more focus should be given to optimizing strategies of high-risk individual assessment and surveillance management to improve compliance with endoscopic examination. Trial Registration: PROSPERO CRD42022375720; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=375720 
%M 37261899
%R 10.2196/45360
%U https://publichealth.jmir.org/2023/1/e45360
%U https://doi.org/10.2196/45360
%U http://www.ncbi.nlm.nih.gov/pubmed/37261899