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Lead-time bias in esophageal cancer screening in high-risk areas in China
OBJECTIVE: To investigate what extent lead-time bias is likely to affect endoscopic screening effectiveness for esophageal cancer in the high-risk area in China. METHODS: A screening model based on the epidemiological cancer registry data, yielding a population-level incidence and mortality rates, w...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491548/ https://www.ncbi.nlm.nih.gov/pubmed/32963459 http://dx.doi.org/10.21147/j.issn.1000-9604.2020.04.04 |
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author | Yang, Zhao Wong, Irene OL Deng, Wei Chen, Ru Zhou, Jiachen Wei, Wenqiang |
author_facet | Yang, Zhao Wong, Irene OL Deng, Wei Chen, Ru Zhou, Jiachen Wei, Wenqiang |
author_sort | Yang, Zhao |
collection | PubMed |
description | OBJECTIVE: To investigate what extent lead-time bias is likely to affect endoscopic screening effectiveness for esophageal cancer in the high-risk area in China. METHODS: A screening model based on the epidemiological cancer registry data, yielding a population-level incidence and mortality rates, was carried out to simulate study participants in the high-risk area in China, and investigate the effect of lead-time bias on endoscopic screening with control for length bias. RESULTS: Of 100,000 participants, 6,150 (6.15%) were diagnosed with esophageal squamous dysplasia during the 20-year follow-up period. The estimated lead time ranged from 1.67 to 5.78 years, with a median time of 4.62 years [interquartile range (IQR): 4.07−5.11 years] in the high-risk area in China. Lead-time bias exaggerated screening effectiveness severely, causing more than a 10% overestimation in 5-year cause-specific survival rate and around a 43% reduction in cause-specific hazard ratio. The magnitude of lead-time bias on endoscopic screening for esophageal cancer varied depending on the screening strategies, in which an inverted U-shaped and U-shaped effects were observed in the 5-year cause-specific survival rate and cause-specific hazard ratio respectively concerning a range of ages for primary screening. CONCLUSIONS: Lead-time bias, usually causing an overestimation of screening effectiveness, is an elementary and fundamental issue in cancer screening. Quantification and correction of lead-time bias are essential when evaluating the effectiveness of endoscopic screening in the high-risk area in China. |
format | Online Article Text |
id | pubmed-7491548 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-74915482020-09-21 Lead-time bias in esophageal cancer screening in high-risk areas in China Yang, Zhao Wong, Irene OL Deng, Wei Chen, Ru Zhou, Jiachen Wei, Wenqiang Chin J Cancer Res Original Article OBJECTIVE: To investigate what extent lead-time bias is likely to affect endoscopic screening effectiveness for esophageal cancer in the high-risk area in China. METHODS: A screening model based on the epidemiological cancer registry data, yielding a population-level incidence and mortality rates, was carried out to simulate study participants in the high-risk area in China, and investigate the effect of lead-time bias on endoscopic screening with control for length bias. RESULTS: Of 100,000 participants, 6,150 (6.15%) were diagnosed with esophageal squamous dysplasia during the 20-year follow-up period. The estimated lead time ranged from 1.67 to 5.78 years, with a median time of 4.62 years [interquartile range (IQR): 4.07−5.11 years] in the high-risk area in China. Lead-time bias exaggerated screening effectiveness severely, causing more than a 10% overestimation in 5-year cause-specific survival rate and around a 43% reduction in cause-specific hazard ratio. The magnitude of lead-time bias on endoscopic screening for esophageal cancer varied depending on the screening strategies, in which an inverted U-shaped and U-shaped effects were observed in the 5-year cause-specific survival rate and cause-specific hazard ratio respectively concerning a range of ages for primary screening. CONCLUSIONS: Lead-time bias, usually causing an overestimation of screening effectiveness, is an elementary and fundamental issue in cancer screening. Quantification and correction of lead-time bias are essential when evaluating the effectiveness of endoscopic screening in the high-risk area in China. AME Publishing Company 2020-08 /pmc/articles/PMC7491548/ /pubmed/32963459 http://dx.doi.org/10.21147/j.issn.1000-9604.2020.04.04 Text en Copyright © 2020 Chinese Journal of Cancer Research. All rights reserved. https://creativecommons.org/licenses/by-nc-sa/4.0/This work is licensed under a Creative Commons Attribution-Non Commercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/ (https://creativecommons.org/licenses/by-nc-sa/4.0/) |
spellingShingle | Original Article Yang, Zhao Wong, Irene OL Deng, Wei Chen, Ru Zhou, Jiachen Wei, Wenqiang Lead-time bias in esophageal cancer screening in high-risk areas in China |
title | Lead-time bias in esophageal cancer screening in high-risk areas in China |
title_full | Lead-time bias in esophageal cancer screening in high-risk areas in China |
title_fullStr | Lead-time bias in esophageal cancer screening in high-risk areas in China |
title_full_unstemmed | Lead-time bias in esophageal cancer screening in high-risk areas in China |
title_short | Lead-time bias in esophageal cancer screening in high-risk areas in China |
title_sort | lead-time bias in esophageal cancer screening in high-risk areas in china |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491548/ https://www.ncbi.nlm.nih.gov/pubmed/32963459 http://dx.doi.org/10.21147/j.issn.1000-9604.2020.04.04 |
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