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Tick box questionnaire could significantly improve esophageal cancer survival rates

Date:
December 5, 2019
Source:
University College London
Summary:
一个简单的健康问卷可以高度effective tool to pre-screen people for early signs of esophageal cancer, enabling much earlier diagnosis and treatment, finds a new study.
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FULL STORY

一个简单的健康问卷可以高度effective tool to pre-screen people for early signs of esophageal cancer, enabling much earlier diagnosis and treatment, finds a UCL-led study.

The research, published in柳叶刀数字医疗, used artificial intelligence to analyse a large esophageal cancer dataset, known as BEST2 (1,299 patients), to establish which health factors were common in those individuals who had Barrett's esophagus.

Barrett's esophagus is a condition where the cells of the esophagus (gullet) grow abnormally and is usually caused by acid reflux. Barrett's esophagus is not a cancer, but is the only known pre-cursor for esophageal cancer, increasing the risk of cancer by 30 to 60 fold.

Significantly, AI found eight factors: age; gender; smoking; waist circumference; frequency of stomach pain; duration of heartburn; acid taste; and taking of acid suppression medicines, which were markers in those individuals who either had Barrett's esophagus or went on to develop it.

As a control, the risk factors identified by AI in BEST2, were then tested on a different esophageal cancer dataset, known as BOOST (398 patients), and the conclusions were the same.

Lead author, Professor Laurence Lovat (UCL Surgery & Interventional Science and UCLH) said: "Our evidence highlights a set of risk factors, which could act as an early warning sign for the likelihood of developing Barrett's esophagus, and potentially esophageal cancer.

"We propose developing a simple tick box questionnaire, identifying risks such as a large waist circumference, severe stomach pain and duration of heartburn, which could be filled out by a GP or by a patient using a mobile phone app.

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"The results would identify a high risk group of people at an early stage, who could then go on to have clinical screening to diagnose and treat esophageal cancer at a much earlier stage and significantly improve survival rates."

Each year, around 9,100 people in the UK are diagnosed with esophageal cancer and the long term survival rate for patients is only 12%, but 59% of cases are preventable.

However there is currently no national screening programme, unlike breast, bowel and cervical cancer, and potential screening methods including endoscopy and cytosponge (sponge on a string) are deemed too invasive or not adequately proven for a national screening programme.

"Early diagnosis is crucial to change disease outcome but symptoms in early esophageal cancer are often either absent or indistinguishable from uncomplicated gastresophageal reflux," added Professor Lovat.

"Barrett's esophagus is the only known precursor and a pre-screening questionnaire could help GPs identify those people, who should have an endoscopy or cytosponge. This approach could also save many people from having invasive tests which eventually turn out to be normal."

There are limitations to this study. Significantly, as both datasets were collected from at-risk individuals, the dataset was enriched for the patients with Barrett's esophagus. A dataset more representative of the general population, with fewer disease instances, could potentially yield different results. This research, known as MARK-BE study, was funded by the Charles Wolfson Charitable Trust and Guts UK and supported by the NIHR UCLH Biomedical Research Centre.


Story Source:

Materialsprovided byUniversity College London.注:内容可能be edited for style and length.


Journal Reference:

  1. Avi Rosenfeld, David G Graham, Sarah Jevons, Jose Ariza, Daryl Hagan, Ash Wilson, Samuel J Lovat, Sarmed S Sami, Omer F Ahmad, Marco Novelli, Manuel Rodriguez Justo, Alison Winstanley, Eliyahu M Heifetz, Mordehy Ben-Zecharia, Uria Noiman, Rebecca C Fitzgerald, Peter Sasieni, Laurence B Lovat, Karen Coker, Wanfeng Zhao, Kathryn Brown, Beverley Haynes, Tara Nuckcheddy Grant, Massimiliano di Pietro, Eleanor Dewhurst, Bincy Alias, Leanne Mills, Caroline Wilson, Elizabeth Bird-Lieberman, Jan Bornschein, Yean Lim, Kareem Shariff, Roberto Cayado Lopez, Myrna Udarbe, Claire Shaw, Glynis Rose, Ian Sargeant, M Al-Izzi, Roisin Schimmel, Elizabeth Green, Morgan Moorghen, Reshma Kanani, Mariann Baulf, Jayne Butcher, Adil Butt, Steve Bown, Gideon Lipman, Rami Sweis, Vinay Sehgal, Matthew Banks, Rehan Haidry, John Louis-Auguste, Darina Kohoutova, Sarah Kerr, Victor Eneh, Nigel Butter, Haroon Miah, Rommel Butawan, Grace Adesina, Sabrina Holohan, Joan Idris, Nick Hayes, Shajahan Wahed, Nelson Kath Houghton, Marc Hopton, Anne Eastick, Debasis Majumdar, Kassem Manuf, Lyndsey Fieldson, Helen Bailey, Jacobo Fernandez-Sordo Ortiz, Mina Patel, Suzanne Henry, Samantha Warburton, Jonathan White, Lisa Gadeke, Beverley Longhurst, Richmond Abeseabe, Peter Basford, Rupam Bhattacharyya, Scott Elliot, Roisin Bevan, Carly Brown, Philippa Laverick, Gayle Clifford, Anita Gibbons, Julie Ingmire, Abdullah Mawas, Jacquelyn Harvey, Sharon Cave.Development and validation of a risk prediction model to diagnose Barrett's oesophagus (MARK-BE): a case-control machine learning approach.The Lancet Digital Health, 2019; DOI:10.1016/S2589-7500(19)30216-X

Cite This Page:

伦敦大学学院。“蜱虫盒问卷could significantly improve esophageal cancer survival rates." ScienceDaily. ScienceDaily, 5 December 2019. /releases/2019/12/191205183421.htm>.
伦敦大学学院。(2019, December 5). Tick box questionnaire could significantly improve esophageal cancer survival rates.ScienceDaily. Retrieved October 24, 2023 from www.koonmotors.com/releases/2019/12/191205183421.htm
伦敦大学学院。“蜱虫盒问卷could significantly improve esophageal cancer survival rates." ScienceDaily. www.koonmotors.com/releases/2019/12/191205183421.htm (accessed October 24, 2023).

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