Early Diagnosis and Treatment Group of the Chinese Medical Association Oncology Branch. [Chinese expert consensus on early diagnosis and treatment of esophageal cancer]

Although the incidence rate of esophageal cancer in China is on the decline, China is still a high-incidence country of esophageal cancer with great regional variation. In recent years, the five-year survival of esophageal cancer in China has improved significantly. However, due to the absence of typical symptoms in early stage, there still exists a large esophageal cancer diagnostic yield gap between China and developed countries. At present, there are no international guidelines defining the target population for esophageal squamous cell carcinoma (ESCC) screening. Exploring and implementing effective esophageal cancer screening together with early diagnosis and early treatment are the keys to reducing the mortality and improving the survival rate and life quality. Endoscopic therapies, such as endoscopic submucosal dissection (ESD), endoscopic mucosal resection (EMR), and radiofrequency ablation (RFA), are used to treat early-stage esophageal cancer. If the tumor invasion is deep or lymph node metastasis is suspected, surgery is needed, meanwhile radiation therapy could also be an optional treatment. Regular follow-up and surveillance are required for any strategy above to deal with relapse and metachronous primary cancers. The Early Diagnosis and Treatment Group of the Chinese Medical Association Oncology Branch has reached an expert consensus on screening and diagnostic protocols for esophageal cancer, on endoscopic and surgical treatment of early esophageal cancer and precancerous lesions, as well as on postoperative monitoring and adjuvant therapy. This consensus follows the evidence-based medicine at both domestic and international levels, combines the current clinical practice and application experience in the treatment of esophageal cancer in China, is based on a multidisciplinary treatment model, and can be used as a reference for clinicians.

[China guideline for the screening, early detection and early treatment of gastric cancer (2022, Beijing)]

Gastric cancer (GC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demons-trated that screening, early detection and early treatment are effective in reducing the incidence and mortality of GC. The development of the guideline for GC screening, early detection and early treatment in line with epidemic characteristics of GC in China will greatly promote the homogeneity and standardization, and improve the effect of GC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of GC screening, China's national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of GC screening and provide scientific evidence for the GC prevention and control in China.

[China guideline for the screening, early detection and early treatment of esophageal cancer (2022, Beijing)]

Esophageal cancer (EC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demonstrated that screening and early detection are effective in reducing the incidence and mortality of EC. The development of the guideline for EC screening and early detection in line with epidemic characteristics of EC in China will greatly promote the homogeneity and standardization, and improve the effect of EC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of EC screening, China's national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of EC screening and provide scientific evidence for the EC prevention and control in China.

[China guideline for the screening, early detection and early treatment of colorectal cancer (2020, Beijing)]

Colorectal cancer (CRC) is a major malignancy threatening the health of people in China, which also leads to heavy social burden. A large number of researches and practices have demonstrated that screening and early detection are effective in reducing the mortality of CRC. It is therefore imperative to design guidelines for the screening, early detection and early treatment of CRC that are in line with national conditions of China based on international guideline development standard. In 2020, under the leadership of the National Cancer Center of China, a multidisciplinary guideline development group was established. The development of the guideline followed the principles and methods recommended by the World Health Organization. The guideline provides detailed recommendations for thirteen key clinical questions to which the professionals who are involved in screening, early detection and early treatment of colorectal cancer paid close attention. The guideline is intended to serve as a tool for professionals providing best decision-making on screening, early detection and early treatment of CRC and to enhance the effectiveness of CRC prevention and control in China.

[A new transition of the screening, early diagnosis and early treatment project of the upper gastrointestinal cancer: opportunistic screening]

The screening, early diagnosis and early treatment project of the upper gastrointestinal cancer had achieved good results since its launch. However, from a national perspective, the endoscopic screening of upper gastrointestinal cancer was still not optimistic, such as the poor rate of the early diagnosis, the low rate of 5-year survival in rural areas, and the disparity of the standardized screening and diagnosis in different areas. Therefore, the situation of upper gastrointestinal cancer prevention and treatment is still severe. Under the guidance of the "Healthy China 2030" plan, based on the international experience and domestic actual circumstance, it is suggested that the screening of high-risk population in high-risk areas should be changed into the opportunistic screening in primary medical institutions. The opportunistic screening could expand the coverage of the screening, early diagnosis and early treatment project of the upper gastrointestinal cancer, and increase the early diagnosis rate in rural areas and primary medical institutions, which could improve the 5-year survival rate of patients with the upper gastrointestinal cancer, and then achieve the sustainable development of the cancer prevention and treatment in China.