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Article: 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 |
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Authors | |
Keywords | Esophageal cancer lead-time bias length bias screening simulation model |
Issue Date | 2020 |
Publisher | Chinese Anti-Cancer Association. The Journal's web site is located at http://cjcr.amegroups.com/ |
Citation | Chinese Journal of Cancer Research, 2020, v. 32 n. 4, p. 467-475 How to Cite? |
Abstract | 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. |
Description | WOS:000565117000004 |
Persistent Identifier | http://hdl.handle.net/10722/290004 |
ISSN | 2023 Impact Factor: 7.0 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | YANG, Z | - |
dc.contributor.author | Wong, IOL | - |
dc.contributor.author | Deng, W | - |
dc.contributor.author | Cheng, R | - |
dc.contributor.author | Zhou, J | - |
dc.contributor.author | Wei, W | - |
dc.date.accessioned | 2020-10-22T08:20:34Z | - |
dc.date.available | 2020-10-22T08:20:34Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Chinese Journal of Cancer Research, 2020, v. 32 n. 4, p. 467-475 | - |
dc.identifier.issn | 1000-9604 | - |
dc.identifier.uri | http://hdl.handle.net/10722/290004 | - |
dc.description | WOS:000565117000004 | - |
dc.description.abstract | 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. | - |
dc.language | eng | - |
dc.publisher | Chinese Anti-Cancer Association. The Journal's web site is located at http://cjcr.amegroups.com/ | - |
dc.relation.ispartof | Chinese Journal of Cancer Research | - |
dc.subject | Esophageal cancer | - |
dc.subject | lead-time bias | - |
dc.subject | length bias | - |
dc.subject | screening | - |
dc.subject | simulation model | - |
dc.title | Lead-time bias in esophageal cancer screening in high-risk areas in China | - |
dc.type | Article | - |
dc.identifier.email | Wong, IOL: iolwong@hku.hk | - |
dc.identifier.authority | Wong, IOL=rp01806 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.21147/j.issn.1000-9604.2020.04.04 | - |
dc.identifier.hkuros | 316289 | - |
dc.identifier.volume | 32 | - |
dc.identifier.issue | 4 | - |
dc.identifier.spage | 467 | - |
dc.identifier.epage | 475 | - |
dc.identifier.isi | WOS:000565117000004 | - |
dc.publisher.place | China | - |
dc.identifier.issnl | 1000-9604 | - |