Screening of upper digestive tract cancer with dilute hydrochloric acid and alcohol in a Chinese high-risk population--a follow-up study of 12 years.

This is a 12-year follow-up study on screening with a mixture of 2% hydrochloric acid and 18% alcohol for upper digestive tract cancer in a Chinese high-risk population. A public screening for upper digestive tract cancer was conducted from November 1979 to May 1984 by giving a mixture of 2% hydrochloric acid and 18% alcohol to 7280 subjects in high-risk population in Yaocun village, Linxian County, Henan province. The subjects were given 15 ml of this mixture in the morning or at noon before lunch when fasting. Five minutes later, irritative reactions (retrosternal discomfort, warmth, pain or pyrosis) was felt in subjects suffering from oesophageal cancer, oesophagitis, gastritis, mucosal dysplasia or ulcer (positive group). Those with normal oesophageal or gastric mucosa felt nothing (negative group). The overall positive rate was 23.2% (1689/7280). In oesophageal or gastric cancer subjects, the positive rate of these symptoms was 88.7%. In subjects with mucosal dysplasia, it was 71.2%. A total of 26 upper digestive tract cancer patients were found. As a result of 12 years' follow-up, 271 persons with upper digestive tract cancer among the 1689 positive group subjects have been discovered, giving an annual morbidity rate of 1.34%. Among the 5591 negative group subjects, 136 persons have been found to suffer from this cancer, giving an annual morbidity rate of 0.2%. This illustrated that the annual morbidity rate of upper digestive tract cancer in the positive group was 6.65 times of that of the negative group ( <0.0001). In conclusion, screening of upper digestive tract cancer with dilute hydrochloric acid in alcohol is simple, safe, non-traumatic, effective and readily acceptable in a high-risk area in China. It may be feasible in other parts of the world, especially the developing countries.