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Endoscopic screening for precancerous lesions of the esophagus in a high risk area in northern Iran

Roshandel, G. and Khoshnia, M. and Sotoudeh, M. and Merat, S. and Etemadi, A. and Nickmanesh, A. and Norouzi, A. and Pourshams, A. and Poustchi, H. and Semnani, S. and Ghasemi-Kebria, F. and Noorbakhsh, R. and Abnet, C. and Dawsey, S.M. and Malekzadeh, R. (2014) Endoscopic screening for precancerous lesions of the esophagus in a high risk area in northern Iran. Archives of Iranian Medicine, 17 (4). pp. 246-252. ISSN 10292977 (ISSN)

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Abstract

Background: Esophageal squamous cell carcinoma (ESCC) is a major health problem in many developing countries, including Iran. ESCC has a very poor prognosis, largely due to late diagnosis. As a first step in developing an early detection and treatment program, we conducted a population-based endoscopic screening for ESCC and its precursor lesion, esophageal squamous dysplasia (ESD), in asymptomatic adults from Golestan Province, northern Iran (a high-risk area for ESCC) to evaluate the feasibility of such a program and to document the prevalence and risk factor correlates of ESD. Methods: This cross-sectional study was conducted among participants of the Golestan Cohort Study (GCS), a population-based cohort of 50,000 adults in eastern Golestan Province. Randomly selected GCS participants were invited by telephone. Those who accepted were referred to a central endoscopy clinic. Eligible subjects who consented were asked to complete a brief questionnaire. Detailed information about selected risk factors was obtained from the GCS main database. Endoscopic examination with was performed with Lugol's iodine staining; biopsies were taken from unstained lesions as well as the normally stained mucosa of the esophagus, and the biopsies were diagnosed by expert pathologists according to previously described criteria. Results: In total, 1906 GCS subjects were invited, of whom only 302 (15.8%) were successfully enrolled. Esophagitis (29.5%) and ESD (6.0%) were the most common pathological diagnoses. Turkmen ethnicity (adjusted OR = 8.61; 95%CI: 2.48-29.83), being older than the median age (OR = 7.7; 95% CI: 1.99-29.87), and using deep frying cooking methods (OR = 4.65; 95%CI: 1.19-18.22) were the strongest predictors for ESD. There were significant relationships between esophagitis and smoking (p-value<0.001), drinking hot tea (P value = 0.02) and lack of education (P value = 0.004). Conclusion: We observed a low rate of participation in endoscopic screening. The overall prevalence of ESD was 6.0%. Developing non-endoscopic primary screening methods and screening individuals with one or more risk factors may improve these rates.

Item Type: Article
Additional Information: Unmapped bibliographic data: LA - English [Field not mapped to EPrints] J2 - Arch. Iran. Med. [Field not mapped to EPrints] C2 - 24724600 [Field not mapped to EPrints] AD - Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran [Field not mapped to EPrints] AD - Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran [Field not mapped to EPrints] AD - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States [Field not mapped to EPrints] DB - Scopus [Field not mapped to EPrints]
Uncontrolled Keywords: Endoscopic screening, Esophageal squamous cell carcinoma, Northern iran, lugol, coloring agent, iodide, Lugol's solution, tea, adult, aged, agitation, article, cancer screening, cohort analysis, cross-sectional study, endoscopy, esophageal squamous cell carcinoma, esophageal squamous dysplasia, esophagitis, esophagus biopsy, esophagus dysplasia, female, gastroesophageal reflux, hiatus hernia, histology, human, Iran, major clinical study, male, precancer, questionnaire, rash, smoking, thorax pain, visual analog scale, vomiting, age, biopsy, cooking, diagnostic use, early diagnosis, educational status, epidemiology, esophagitis, esophagoscopy, esophagus, ethnology, middle aged, pathology, prevalence, procedures, risk factor, tea, very elderly, Adult, Age Factors, Aged, Aged, 80 and over, Biopsy, Coloring Agents, Cooking, Cross-Sectional Studies, Early Detection of Cancer, Educational Status, Esophagitis, Esophagoscopy, Esophagus, Female, Humans, Iodides, Iran, Male, Middle Aged, Precancerous Conditions, Prevalence, Risk Factors, Smoking, Tea
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
موارد کلی
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 15 Apr 2015 09:07
Last Modified: 09 May 2015 05:26
URI: http://eprints.goums.ac.ir/id/eprint/1746

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