![]() All participants received endoscopy screening and pathological biopsy for free. Therefore, the study was intended to evaluate the biological correlates of EC screening and subsequent diagnosis on cortisol and immunoglobulin levels in China and provide essential evidence and multi-facet evaluation EC screening.īased on the NCEC program, a prospective, multicenter (Linzhou, Cixian) study in high-risk EC regions was conducted from 2017 to 2019 24. Evidence in this field of esophageal cancer is sparse. Biological correlates of cancer screening and diagnosis have not been definitively identified. At present, the potential negative influence of EC screening and diagnosis is dramatically overlooked in China. ![]() Objective indicators (cortisol and immunoglobulin) are more convincing compared with traditional surveys based on subjective questionnaires 23. Moreover, the abnormal stressor further weakens the immune function through the neuroendocrine-immune network, which plays a vital role in disease progression 15, 21, 22. The plausible biological mechanisms have been proposed that stressor stimulates and imbalances the hypothalamic–pituitary–adrenal axis (HPA), then cortisol (an essential stress hormone) is released increasingly 17, 18, 19, 20. Growing evidence has shown that screening and diagnosis may be a stressor that stimulates participants in physical and mental ways 14, 15, 16. Although several EC screening programs in high prevalence regions of China have demonstrated the efficacy of endoscopic screening in reducing the incidence and mortality of EC 5, 6, 7, 8, false-positive results, over-diagnosis, psychological burden, and biological change due to cancer screening are increasingly recognized 9, 10, 11, 12, 13. The impact of cancer screening has long been a controversial topic according to its benefits and disadvantages. It may be dramatic and life-threatening, causing a considerable burden on patients, families, and society 3, 4. Nearly 50% of the world's new cases occur in China 1, 2. Further multi-round longitudinal studies are needed to validate these results.Įsophageal cancer (EC) is one of the most common cancers in the world, and is a leading cause of cancer death, with 604,000 new cases and 544,000 deaths in 2020 1. Cortisol and IgA dropped less significantly, while IgM and IgA were increased slightly after diagnosis. ![]() Little biological correlates were found both before screening and after diagnosis. No interaction effects on biological levels between pre-post screening and esophageal pathology, anxiety states (all P > 0.05). ![]() Repeated Measures ANOVA showed that the main effects were significant on IgA levels between pre-screening and post-diagnosis ( P = 0.019). No significant differences in biological indicators were found between normal and esophagitis and low-grade intraepithelial neoplasia before screening and after diagnosis. Box–Cox-power transformation and two-way repeated measures ANOVA were used to evaluate hormone cortisol and immunoglobulin (IgA, IgG, IgM) levels in plasma, reflecting their stress, immune function, and biological correlates before screening and after knowing the diagnosis. 61 participants received twice esophageal endoscopy screening and pathological biopsy successively (with a mean follow-up of 14.03 months). Based on the national cohort of esophageal cancer program, a prospective multicenter study in high-risk regions was conducted from 2017 to 2019. The study was designed to evaluate the biological correlates of EC screening and subsequent diagnosis in China. Almost 50% of the world’s esophageal cancer (EC) cases occur in China, and the impact of cancer screening has long been a controversial topic. ![]()
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