Health risk appraisal models for mass screening for esophageal and pharyngeal cancer: An endoscopic follow-up study of cancer-free japanese men

Akira Yokoyama, Yoshiya Kumagai, Tetsuji Yokoyama, Tai Omori, Hoichi Kato, Hiroyasu Igaki, Toshimasa Tsujinaka, Manabu Muto, Masako Yokoyama, Hiroshi Watanabe

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)

Abstract

Purpose: To assess the performance of our health risk appraisal (HRA) models for screening individuals at high risk of esophageal/pharyngeal squamous cell carcinoma (EPSCC). Methods: Based on the results of our previous case-control study, we invented HRA models that enable screening for EPSCC cases in Japanese men with high sensitivity and specificity based on either their aldehyde dehydrogenase-2 genotype (HRA-G model) or alcohol flushing (HRA-F model) and drinking, smoking, and dietary habits. Follow-up endoscopy combined with esophageal iodine staining (median follow-up period: 5.0 years) was done on 404 Japanese men (50-78 years) who were registered as cancer-free controls in the previous study. Results: The follow-up endoscopy resulted in a diagnosis of 6 esophageal SCC (Tis in 5 and T1 in 1), 1 hypopharyngeal SCC (T2), and 1 oropharyngeal SCC (T2). Seven and 6 of the 8 EPSCC cases were in the top 10% risk group at baseline according to the HRA-G and HRA-F models, respectively. The EPSCC detection rates per 100 person-years in the top 10% risk groups by the HRA-G and HRA-F models were 4.38 (95% confidence interval, 1.76-9.01) and 3.48 (95% confidence interval, 1.28-7.58), respectively. Their age-adjusted relative risk was 95.1- and 26.3-fold, respectively (P < 0.0001), higher than in the bottom 90% risk groups. Conclusions: The high detection rates for EPSCC in the top 10% risk group of this preliminary follow-up study were in good agreement with those predicted by the HRA models and thus encouraged the screening based on our HRA models in larger populations of Japanese men.

Original languageEnglish
Pages (from-to)651-655
Number of pages5
JournalCancer Epidemiology Biomarkers and Prevention
Volume18
Issue number2
DOIs
Publication statusPublished - 2009 Feb

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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