Abstract: Objective The aim of this study was to analyze the results and cost-effectiveness of upper gastrointestinal cancer screening under the Cancer Early Diagnosis and Treatment Project in the Huaihe River Basin of Huai′an City,Jiangsu Province from 2022 to 2024,and to provide a scientific basis for further optimizing regional upper gastrointestinal cancer prevention and control strategies. Methods A cluster sampling method was employed to select residents aged 40 to 75 who participated in the upper gastrointestinal cancer screening under the Cancer Early Diagnosis and Treatment Project in the Huaihe River Basin of Huai′an City from 2022 to 2024 as the study subjects.Health factor surveys and high-risk assessments were conducted among the target population,and high-risk individuals were mobilized to undergo endoscopy and pathological diagnosis.The high-risk rate,compliance rate,detection rate,and early diagnosis rate of participants with different characteristics were compared.Screening cost data were verified,and a health economic evaluation was conducted. Results From 2022 to 2024,a total of 26,081 health factor surveys were completed,identifying 14,629 high-risk individuals for upper gastrointestinal cancer,with a high-risk rate of 56.09%.Among them,a total of 10,128 individuals underwent endoscopy,with a compliance rate of 69.23%,which was higher in females than that in males(P＜0.001).A total of 137 positive cases of upper gastrointestinal cancer were detected,with a detection rate of 1.35%,which was higher in males than that in females(P＜0.001).No positive cases were detected in the 40-49 age group,with the highest detection rate in the 70-74 age group.There were 82 early-stage cases,with an early diagnosis rate of 59.85%.The cost-effectiveness analysis showed that the cost per detected positive case and early-case was 35,423.36 yuan and 59,182.93 yuan,respectively.The early detection cost index(EDCI)was 0.57,indicating that the screening project had good health economic value. Conclusions The upper gastrointestinal cancer screening under the Cancer Early Diagnosis and Treatment Project in the Huai′an City,Jiangsu Province,has good cost-effectiveness.In the future,health education for the male population should be strengthened to improve their compliance with endoscopic screening,and special attention should be paid to screening for individuals over 50 years old to further enhance the effectiveness of upper gastrointestinal cancer screening.

Key words: upper gastrointestinal cancer, screening, Huaihe River Basin, cost-effectiveness analysis