Improved Effectiveness of Combined Screening for Multiple Cancers - A Government-Organized Population-Based Study in China

Sep 21, 2026

Objective analyzes the effectiveness of the Cancer Screening Program in Urban China (CanSPUC) in Hebei Province from 2016 to 2023. Methods administers a questionnaire on risk factors for lung, breast, upper gastrointestinal, liver, and colorectal cancers among urban residents aged 40–74, then invites high-risk participants for screening and groups them by the number of cancer types assessed as high risk. Results include 237,975 eligible participants and mortality reductions versus non-screened groups. Conclusion supports combined multi-cancer screening with constrained health resources.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Introduction

Cancer burden and rationale for screening

National and international evidence for screening methods

Methods

Risk-factor questionnaire and high-risk classification

Screening participation and outcomes

Statistical evaluation with inverse probability weighting

Results

Study enrollment and high-risk prevalence

Screening participation, positive and suspected outcomes

Comparative participation and outcome rates by cancer types risk

Mortality and incidence comparisons

Cancer Medicine | RESEARCH ARTICLE OPEN ACCESS
Improved Effectiveness of Combined Screening for Multiple Cancers: A Government-Organized Population-Based Study in China
Qian Lu1,2 | Di Liang1 | Jin Shi1 | Siqi Wu1 | Xinyu Du1,2 | Yutong He1,2
1Cancer Institute in Hebei Province, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China | 2School of Public Health, Hebei Medical University, Shijiazhuang, China
Correspondence: Yutong He ([heyutong@hebmu.edu.cn](heyutong@hebmu.edu.cn))
Received: 18 July 2024 | Revised: 19 September 2024 | Accepted: 28 September 2024
Funding: The authors received no specific funding for this work.
Keywords: cancer | compliance | effectiveness | risk assessment | screening | | | --- | --- | | ABSTRACT
Objective: The purpose of this study was to analyze the effectiveness of the Cancer Screening Program in Urban China (CanSPUC) in Hebei Province, 2016–2023.
Methods: A questionnaire for risk factors of lung, breast, upper gastrointestinal, liver, and colorectal cancers was administered to urban residents aged 40–74 years in five cities to assess their cancer risk. High-risk participants were invited for screening and classified into five groups on the basis of the number of cancer types that were assessed to be high risk. The participation and positive outcome rates were analyzed. The incidence and the mortality of five types of cancer and all-cause mortality of the screened and nonscreened participants were calculated via inverse probability weighting.
Results: A total of 237,975 eligible participants were enrolled in our study and 118,339 participants (49.94%) were assessed to beat high risk for one or more of the five cancer types. The number of screenings performed was 103,824, with a screening participation rate of 40.49% . Among the 57,315 screening participants, 9077 (15.84%) had positive cancer diagnoses and 871 (1.52%) were diagnosed with suspected cancer. Compared with the participants at high risk for a single cancer type, the participation and positive outcome rate increased by 45% and 71.5% in the participants at high risk for multiple cancer types. Compared with the non-screened participants, the screened participants had a 27.0% decrease in mortality due to the five types of cancer and a 45.8% decrease in all-cause mortality.
Conclusion: A combined screening program for multiple cancers could increase participation and positive outcome rates. It could also decrease the five types of cancer mortality and all-cause mortality. Our findings highlight the effectiveness of combined screening for multiple cancers with limited health care resources, and may provide foundational evidence for the feasibility of conducting combined screening programs. | | | 1 | Introduction | [1] . There were approximately 4.8 million new cancer cases and | | GLOBOCAN 2022 reported that there were close to 20 million new cases of cancer in 2022 as well as 9.7 million cancer deaths | 2.6 million cancer deaths in China. Lung cancer, liver cancer, gastric cancer, colorectal cancer, and esophageal cancer are the top five cancers leading to death and account for 67.5% of | | Qian Lu and Di Liang are co-first authors of the article. | | | This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd. | | Cancer Medicine, 2024; 13:e70463 1 of 12 [https://doi.org/10.1002/cam4.70463](https://doi.org/10.1002/cam4.70463) all cancer deaths [2] . Sufficient and credible evidence in recent decades has demonstrated that screening reduces the mortality of several common cancers in the USA and other high-income countries [3]. The US National Lung Screening Trial (NLST) and Dutch–Belgian Lung Cancer Screening Trial (NELSON), reported that low-dose computed tomog

FAQs

What is the study objective in CanSPUC (2016–2023)?

To analyze the effectiveness of the Cancer Screening Program in Urban China (CanSPUC) in Hebei Province between 2016 and 2023.

How were participants assessed for cancer risk before screening?

Urban residents aged 40–74 completed a questionnaire covering lung, breast, upper gastrointestinal, liver, and colorectal cancer risk factors, and high-risk participants were invited for screening.

What main benefit did screening show compared with no screening?

Compared with non-screened participants, screened participants had a 27.0% decrease in mortality due to the five cancer types and a 45.8% decrease in all-cause mortality.

Sep 21, 2026

Uploaded by Seraphina