Abstract
BackgroundHuman papillomavirus (HPV) has been observed repeatedly in esophageal squamous cell carcinoma (ESCC) tissues. However, the causal relationship between HPV infection and the onset of ESCC remains unknown. A large cohort study focusing on this topic is being carried out in rural Anyang, China.Methodology/Principal FindingsThe Anyang Esophageal Cancer Cohort Study (AECCS) is a population-based prospective endoscopic cohort study designed to investigate the association of HPV infection and ESCC. This paper provides information regarding the design and implementation of this study. In particular we describe the recruitment strategies and quality control procedures which have been put into place, and the custom designed computer-aided survey system (CASS) used for this project. This system integrates barcode technology and unique identification numbers, and has been developed to facilitate real-time data management throughout the workflow using a wireless local area network. A total of 8,112 (75.3%) of invited subjects participated in the baseline endoscopic examination; of those invited two years later to take part in the first cycle of follow-up, 91.9% have complied.Conclusions/SignificanceThe AECCS study has high potential for evaluating the causal relationship between HPV infection and the occurrence of ESCC. The experience in setting up the AECCS may be beneficial for others planning to initiate similar epidemiological studies in developing countries.
Highlights
Esophageal cancer is a common and often fatal malignancy, and it shows a striking geographic variation in incidence [1,2]
A case-control study in this population observed that the presence of Human papillomavirus (HPV) DNA in cancer specimens and the presence of HPV-16 E7 antibody in sera were associated with an increased risk of esophageal squamous cell carcinoma (ESCC) (Unpublished manuscript)
In order to further investigate the causal relationship between HPV infection and the incidence of ESCC, the Anyang Esophageal Cancer Cohort Study (AECCS) was launched in 2006
Summary
Esophageal cancer is a common and often fatal malignancy, and it shows a striking geographic variation in incidence [1,2]. The association between human papillomavirus (HPV) infection and esophageal squamous cell carcinoma (ESCC) has been under investigation since the early 1980s, and results have been inconsistent [8,9,10,11,12,13,14]. A case-control study in this population observed that the presence of HPV DNA in cancer specimens and the presence of HPV-16 E7 antibody in sera were associated with an increased risk of ESCC (Unpublished manuscript). In order to further investigate the causal relationship between HPV infection and the incidence of ESCC, the Anyang Esophageal Cancer Cohort Study (AECCS) was launched in 2006. Human papillomavirus (HPV) has been observed repeatedly in esophageal squamous cell carcinoma (ESCC) tissues. A large cohort study focusing on this topic is being carried out in rural Anyang, China
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