The discrimination model 2 and model 4 only included the five tra

The discrimination model 2 and model 4 only included the five traditional risk factors. ESCD, esophageal squamous cells dyspalsia; ESCC, esophageal squamous cells cancer. Discussion In a retrospective death

survey Z-VAD-FMK supplier carried out in the 1970s, Feicheng County was second only to Lin County of Henan Province as the area with the highest incidence of ESCC [15]. For the past 35 years, the mortality rate of ESCC has remained high in Feicheng County [16]. Epidemiological research has shown that there is a difference in the risk factors related to ESSC in the two areas [17, 18]. We carried out a program of endoscope screening for esophageal lesions using 1.2% iodine staining

between January 2004 and December 2006 in Fetching County. The study included all of the residents aged from 40 to 69, who agreed to participate in the program after explanation of the purpose of the study. Prior to this study, we had conducted a case-control study of esophageal cancer based on hospital ICG-001 cost data from Feicheng. This study found that esophageal cancer was associated with the risk factors of smoking, alcohol drinking and family history of the disease. In the screening explanation, we therefore especially encouraged those persons who were heavy smokers or drinkers, or who had a positive family history of esophageal cancer, to participate in the study and undergo endoscopic inspection [19]. Based on the screening data, we carried out another case-control study. There were 235 ESCC cases (70 early cancers identified in screening program, 183 were advanced cancer diagnosed in hospitalized patients) and 8159 controls who were confirmed clear by endoscopy and mucosal staining in the screening program. After adjusting for the three confounders (age, sex and education), we found that smoking and alcohol drinking were the top ranked risk factors for esophageal cancer. When smoking and alcohol drinking

were combined, the OR was 2.73 (95% CI : 1.54-4.82), Casein kinase 1 and the proportional attribute relative risk was 51.47 per cent for males. When smoking, alcohol drinking and family history of esophageal cancer were combined, the OR was 3.40 (95% CI : 1.68-6.89), and the proportional attribute relative risk was 15.4 per cent for males [20]. The risk factors identified in the study were consistent with the results of our previous case-control study based on hospital data. Although there was no test fee charged for our screening survey, the response rate of residents participating was very low. The main reason was lack of a method to identify high-risk persons who may be suffering from esophageal premalignant diseases, and to persuade these persons to participate in the endoscopic examination.

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