Performance of screening tests for oesophageal squamous cell carcinoma: a systematic review and meta-analysis

Wong, M. C., Deng, Y., Huang, J., Bai, Y., Wang, H. H.X. , Yuan, J., Zhang, L., Yip, H. C. and Yan Chiu, P. W. (2022) Performance of screening tests for oesophageal squamous cell carcinoma: a systematic review and meta-analysis. Gastrointestinal Endoscopy, 96(2), 197-207.e34. (doi: 10.1016/j.gie.2022.04.005) (PMID:35413332)

Abstract

Background and Aims: This systematic review and meta-analysis aims to compare the pooled diagnostic accuracy of the currently available esophageal squamous cell carcinoma (ESCC) screening tests. Methods: A comprehensive literature search of Embase and Medline (up to October 31, 2020) was performed to identify eligible studies. We pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) for ESCC screening tools using a bivariate random-effects model. The summary receiver operating characteristic (sROC) curves with area under the curve (AUC) were plotted for each screening test. Results: We included 161 studies conducted in 81 research articles involving 32,209 subjects. The pooled sensitivity, specificity, and AUC (95% CIs) of the major screening tools were: (1). Endoscopy (per-oral endoscopy): 0.94 (0.87-0.97), 0.92 (0.87-0.95), and 0.97 (0.96-0.99); (2) Endoscopy (transnasal endoscopy): 0.85 (0.70-0.93), 0.96 (0.91-0.98), and 0.97 (0.95, -0.98); (3). MicroRNA: 0.77 (0.75-0.80), 0.78 (0.75-0.80), and 0.85 (0.81-0.87); (4). Autoantibody: 0.45 (0.36-0.53), 0.91 (0.89-0.93), and 0.84 (0.81-0.87); and (5). Cytology: 0.82 (0.60-0.93), 0.97 (0.88-0.99), and 0.97 (0.95-0.98). There was high heterogeneity. Conclusions: The diagnostic accuracy seems comparable between Cytology and endoscopy, whilst autoantibody and microRNAs bear potential as future non-invasive screening tools for ESCC. To reduce ESCC-related death in the high-risk populations, it is important to develop a more accurate and less invasive screening test.

• Item Type: Articles
• Keywords: Esophageal cancer, specificity, screening, sensitivity, accuracy.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Wang, Professor Haoxiang
• Authors: Wong, M. C., Deng, Y., Huang, J., Bai, Y., Wang, H. H.X., Yuan, J., Zhang, L., Yip, H. C., and Yan Chiu, P. W.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Gastrointestinal Endoscopy
• Publisher: Elsevier
• ISSN: 0016-5107
• ISSN (Online): 1097-6779
• Published Online: 09 April 2022
• Copyright Holders: Copyright © 2022 American Society for Gastrointestinal Endoscopy
• First Published: First published in Gastrointestinal Endoscopy 96(2): 197-207.e34
• Publisher Policy: Reproduced under a Creative Commons License