Background
Methods
Study design
Study participants
Instruments
Covariate variables
Statistics
Ethics statement
Results
The screening detection and diagnosis of different esophageal lesions
Baseline characteristics of participants with different esophageal lesions
Characteristics | Esophageal pathology | Chi-square test | P Value | |||||
---|---|---|---|---|---|---|---|---|
Health N = 10,907 | Esophagitis N = 4048 | LGIN N = 769 | HGIN N = 157 | EC N = 55 | Total N = 15,936 | |||
Age, (Mean ± SD) | 54.48 ± 7.66 | 56.65 ± 7.53 | 60.65 ± 6.23 | 62.71 ± 5.86 | 61.49 ± 6.42 | 55.44 ± 7.74 | 466.28a | < 0.001 |
PHQ-9 score, Median (Q1-Q3) | 1.00 (0.00–4.00) | 0.00 (0.00–4.00) | 0.00 (0.00–4.00) | 1.00 (0.00–4.00) | 1.00 (0.00–4.00) | 0.00 (0.00–4.00) | 159.74b | < 0.001 |
Age (years), n (%) | 249.37 | < 0.001 | ||||||
≤ 50 | 3776 (34.62) | 963 (23.79) | 48 (6.24) | 5 (3.18) | 3 (5.45) | 4795 (30.09) | ||
51–60 | 4249 (38.96) | 1636 (40.42) | 292 (37.97) | 40 (25.48) | 17 (30.91) | 6234 (39.12) | ||
> 60 | 2882 (26.42) | 1449 (35.81) | 429 (55.79) | 112 (71.34) | 35 (63.64) | 4907 (30.79) | ||
Gender, n (%) | 12.74 | 0.013 | ||||||
Male | 4471 (40.99) | 1686 (41.65) | 337 (43.82) | 79 (50.32) | 31 (56.36) | 6604 (41.44) | ||
Female | 6436 (59.01) | 2362 (58.35) | 432 (56.18) | 78 (49.68) | 24 (43.64) | 9332 (58.56) | ||
Region, n (%) | 186.87 | < 0.001 | ||||||
Linzhou | 1260 (11.55) | 767 (18.95) | 170 (22.11) | 38 (24.2) | 13 (23.64) | 2248 (14.11) | ||
Cixian | 2878 (26.39) | 1041 (25.72) | 203 (26.4) | 44 (28.03) | 15 (27.27) | 4181 (26.24) | ||
Feicheng | 3222 (29.54) | 375 (9.26) | 212 (27.57) | 35 (22.29) | 19 (34.55) | 3863 (24.24) | ||
Yanting | 3193 (29.27) | 146 (3.61) | 77 (10.01) | 32 (20.38) | 6 (10.91) | 3454 (21.67) | ||
Yangzhong | 354 (3.25) | 1719 (42.47) | 107 (13.91) | 8 (5.1) | 2 (3.64) | 2190 (13.74) | ||
Marital status, n (%) | 76.66 | < 0.001 | ||||||
Married | 10,294 (94.38) | 3682 (90.96) | 689 (89.60) | 137 (87.26) | 49 (89.09) | 14,851 (93.19) | ||
Unmarried/Living alone/divorced/widowed | 613 (5.62) | 366 (9.04) | 80 (10.40) | 20 (12.74) | 6 (10.91) | 1085 (6.81) | ||
Highest education level, n (%) | 86.02 | < 0.001 | ||||||
Primary school or below | 5393 (49.45) | 1845 (45.58) | 454 (59.04) | 104 (66.24) | 35 (63.64) | 7831 (49.14) | ||
Junior or senior high school | 5424 (49.73) | 2152 (53.16) | 313 (40.7) | 53 (33.76) | 20 (36.36) | 7962 (49.96) | ||
Undergraduate or over | 83 (0.76) | 44 (1.09) | 2 (0.26) | 0 (0.00) | 0 (0.00) | 129 (0.81) | ||
Unknown | 7 (0.06) | 7 (0.17) | 0 (0.00) | 0 (0.00) | 0 (0.00) | 14 (0.09) | ||
Occupation, n (%) | 761.90 | < 0.001 | ||||||
Agriculture or related workers | 7140 (65.46) | 1745 (43.11) | 495 (64.37) | 121 (77.07) | 46 (83.64) | 9547 (59.91) | ||
Factory workers | 1393 (12.77) | 947 (23.39) | 76 (9.88) | 9 (5.73) | 2 (3.64) | 2427 (15.23) | ||
Housewife or househusband | 1296 (11.88) | 646 (15.96) | 128 (16.64) | 16 (10.19) | 3 (5.45) | 2089 (13.11) | ||
Administrator or manager or professional or technical | 216 (1.98) | 114 (2.82) | 13 (1.69) | 2 (1.27) | 1 (1.82) | 346 (2.17) | ||
Self-employed or sales or service workers | 552 (5.06) | 309 (7.63) | 20 (2.60) | 2 (1.27) | 1 (1.82) | 884 (5.55) | ||
Retired | 97 (0.89) | 115 (2.84) | 9 (1.17) | 4 (2.55) | 0 (0.00) | 225 (1.41) | ||
Unemployed | 42 (0.39) | 29 (0.72) | 4 (0.52) | 1 (0.66) | 0 (0.00) | 76 (0.48) | ||
Unknown | 171 (1.57) | 143 (3.53) | 24 (3.12) | 2 (1.27) | 2 (3.64) | 342 (2.15) | ||
Household income (ten thousand RMB/year), n (%) | 1147.08 | < 0.001 | ||||||
< 3.0 | 1591 (14.59) | 631 (15.59) | 211 (27.44) | 48 (30.57) | 11 (20) | 2492 (15.64) | ||
3.0–7.0 | 6617 (60.67) | 1579 (39.01) | 367 (47.72) | 78 (49.68) | 33 (60) | 8674 (54.43) | ||
7.0–11.0 | 2247 (20.6) | 1046 (25.84) | 142 (18.47) | 26 (16.56) | 11 (20) | 3472 (21.79) | ||
≥ 11.0 | 452 (4.14) | 792 (19.57) | 49 (6.37) | 5 (3.18) | 0 (0.00) | 1298 (8.15) | ||
Smoking status, n (%) | 22.80 | 0.004 | ||||||
Do not smoke | 8640 (79.22) | 3099 (76.56) | 602 (78.28) | 117 (74.52) | 36 (65.45) | 12,494 (78.40) | ||
Only occasionally | 331 (3.03) | 136 (3.36) | 17 (2.21) | 6 (3.82) | 1 (1.82) | 491 (3.08) | ||
Most days/almost every day | 1936 (17.75) | 813 (20.08) | 150 (19.51) | 34 (21.66) | 18 (32.73) | 2951 (18.52) | ||
Alcohol consumption, n (%) | 57.13 | < 0.001 | ||||||
Never or almost never | 6922 (63.46) | 2614 (64.58) | 510 (66.32) | 91 (57.96) | 27 (49.09) | 10,164 (63.78) | ||
Only occasionally | 2535 (23.24) | 806 (19.91) | 135 (17.56) | 31 (19.75) | 10 (18.18) | 3517 (22.07) | ||
Most days/almost every day | 1450 (13.29) | 628 (15.51) | 124 (16.12) | 35 (22.29) | 18 (32.73) | 2255 (14.15) | ||
Tea consumption, n (%) | 414.12 | < 0.001 | ||||||
Never or almost never | 5190 (47.58) | 2641 (65.24) | 440 (57.22) | 88 (56.05) | 27 (49.09) | 8386 (52.62) | ||
Only occasionally | 2564 (23.51) | 694 (17.14) | 111 (14.43) | 35 (22.29) | 8 (14.55) | 3412 (21.41) | ||
Most days/almost every day | 3153 (28.91) | 713 (17.61) | 218 (28.35) | 34 (21.66) | 20 (36.36) | 4138 (25.97) | ||
Physical activities, n (%) | 132.70 | < 0.001 | ||||||
Never or almost never | 9544 (87.5) | 3344 (82.61) | 665 (86.48) | 137 (87.26) | 49 (89.09) | 13,739 (86.21) | ||
1–2 times / week | 217 (1.99) | 160 (3.95) | 14 (1.82) | 2 (1.27) | 1 (1.82) | 394 (2.47) | ||
3–5 times / week | 170 (1.56) | 163 (4.03) | 10 (1.30) | 1 (0.64) | 1 (1.82) | 345 (2.16) | ||
Daily/almost every day | 976 (8.95) | 381 (9.41) | 80 (10.40) | 17 (10.83) | 4 (7.27) | 1458 (9.15) | ||
Life satisfaction status, n (%) | 36.46 | < 0.001 | ||||||
Very satisfied | 2307 (21.15) | 774 (19.12) | 181 (23.54) | 34 (21.66) | 10 (18.18) | 3306 (20.75) | ||
Basically satisfied | 7622 (69.88) | 2817 (69.59) | 503 (65.41) | 112 (71.34) | 38 (69.09) | 11,092 (69.60) | ||
General | 948 (8.69) | 432 (10.67) | 82 (10.66) | 10 (6.37) | 7 (12.73) | 1479 (9.28) | ||
Not satisfied | 30 (0.28) | 25 (0.62) | 3 (0.39) | 1 (0.64) | 0 (0.00) | 59 (0.37) | ||
Self-rated health status, n (%) | 254.46 | < 0.001 | ||||||
Excellent | 2592 (23.76) | 739 (18.26) | 191 (24.84) | 36 (22.93) | 14 (25.45) | 3572 (22.41) | ||
Good | 6449 (59.13) | 2169 (53.58) | 382 (49.67) | 82 (52.23) | 26 (47.27) | 9108 (57.15) | ||
General | 1766 (16.19) | 1092 (26.98) | 188 (24.45) | 36 (22.93) | 15 (27.27) | 3097 (19.43) | ||
Fair-poor | 100 (0.92) | 48 (1.19) | 8 (1.04) | 3 (1.91) | 0 (0.00) | 159 (1.00) | ||
BMI (kg/m2), n (%) | 31.67 | 0.002 | ||||||
< 18.5 | 187 (1.71) | 79 (1.95) | 18 (2.34) | 5 (3.18) | 1 (1.82) | 290 (1.82) | ||
18.5–25.0 | 6107 (55.99) | 2364 (58.40) | 458 (59.56) | 102 (64.97) | 36 (65.45) | 9067 (56.90) | ||
25.0–30.0 | 3900 (35.76) | 1402 (34.63) | 253 (32.90) | 44 (28.03) | 17 (30.91) | 5616 (35.24) | ||
≥ 30.0 | 713 (6.54) | 203 (5.01) | 40 (5.20) | 6 (3.82) | 1 (1.82) | 963 (6.04) | ||
Depression symptoms | 27.54 | < 0.001 | ||||||
Depression (PHQ-9 ≥ 7) | 505 (4.63) | 121 (2.99) | 23 (2.99) | 9 (5.73) | 5 (9.09) | 663 (4.16) | ||
Non-depression (PHQ-9 < 7) | 10,402 (95.37) | 3927 (97.01) | 746 (97.01) | 148 (94.27) | 50 (90.91) | 15,273 (95.84) |
The depression symptoms of participants with esophageal lesions
Characteristics | Depression | Non-depression | Total | Chi-square test | P Value | |||
---|---|---|---|---|---|---|---|---|
n = 663 | % | n = 15,273 | % | n = 15,936 | % | |||
Age (Mean ± SD) | 55.45 ± 7.51 | 55.44 ± 7.75 | 55.44 ± 7.74 | -0.047a | 0.963 | |||
Age (years) | 0.29 | 0.867 | ||||||
≤ 50 | 194 | 29.26 | 4601 | 30.13 | 4795 | 30.09 | ||
51–60 | 265 | 39.97 | 5969 | 39.08 | 6234 | 39.12 | ||
> 60 | 204 | 30.77 | 4703 | 30.79 | 4907 | 30.79 | ||
Gender | 0.30 | 0.587 | ||||||
Male | 268 | 40.42 | 6336 | 41.48 | 6604 | 41.44 | ||
Female | 395 | 59.58 | 8937 | 58.52 | 9332 | 58.56 | ||
Region | 181.80 | < 0.001 | ||||||
Linzhou | 70 | 10.56 | 2178 | 14.26 | 2248 | 14.11 | ||
Cixian | 217 | 32.73 | 3964 | 25.95 | 4181 | 26.24 | ||
Feicheng | 94 | 14.18 | 3769 | 24.68 | 3863 | 24.24 | ||
Yanting | 253 | 38.16 | 3201 | 20.96 | 3454 | 21.67 | ||
Yangzhong | 29 | 4.37 | 2161 | 14.15 | 2190 | 13.74 | ||
Marital status | 1.64 | 0.200 | ||||||
Married | 626 | 94.42 | 14,225 | 93.14 | 14,851 | 93.19 | ||
Unmarried/Living alone/divorced/widowed | 37 | 5.58 | 1048 | 6.86 | 1085 | 6.81 | ||
Highest education level | 9.78 | 0.021 | ||||||
Primary school or below | 350 | 52.79 | 7481 | 48.98 | 7831 | 49.14 | ||
Junior or senior high school | 304 | 45.85 | 7658 | 50.14 | 7962 | 49.96 | ||
Undergraduate or over | 6 | 0.90 | 123 | 0.81 | 129 | 0.81 | ||
Unknown | 3 | 0.45 | 11 | 0.07 | 14 | 0.09 | ||
Occupation | 111.59 | < 0.001 | ||||||
Agriculture or related workers | 519 | 78.28 | 9028 | 59.11 | 9547 | 59.91 | ||
Factory workers | 44 | 6.64 | 2383 | 15.60 | 2427 | 15.23 | ||
Housewife or househusband | 56 | 8.45 | 2033 | 13.31 | 2089 | 13.11 | ||
Administrator or manager or professional or technical | 12 | 1.81 | 334 | 2.19 | 346 | 2.17 | ||
Self-employed or sales or service workers | 17 | 2.56 | 867 | 5.68 | 884 | 5.55 | ||
Retired | 5 | 0.75 | 220 | 1.44 | 225 | 1.41 | ||
Unemployed | 2 | 0.30 | 74 | 0.48 | 76 | 0.48 | ||
Unknown | 8 | 1.21 | 334 | 2.19 | 342 | 2.15 | ||
Household income (ten thousand RMB/year) | 20.99 | 0.006 | ||||||
< 3.0 | 85 | 12.82 | 2407 | 15.76 | 2492 | 15.64 | ||
3.0–7.0 | 412 | 62.14 | 8262 | 54.10 | 8674 | 54.43 | ||
7.0–11.0 | 132 | 19.91 | 3340 | 21.87 | 3472 | 21.79 | ||
≥ 11.0 | 34 | 5.13 | 1264 | 8.28 | 1298 | 8.15 | ||
Smoking status | 0.88 | 0.644 | ||||||
Do not smoke | 529 | 79.79 | 11,965 | 78.34 | 12,494 | 78.40 | ||
Only occasionally | 18 | 2.71 | 473 | 3.10 | 491 | 3.08 | ||
Most days or almost every day | 116 | 17.50 | 2835 | 18.56 | 2951 | 18.52 | ||
Alcohol consumption | 57.81 | < 0.001 | ||||||
Never or almost never | 415 | 62.59 | 9749 | 63.83 | 10,164 | 63.78 | ||
Only occasionally | 205 | 30.92 | 3312 | 21.69 | 3517 | 22.07 | ||
Most days or almost every day | 43 | 6.49 | 2212 | 14.48 | 2255 | 14.15 | ||
Tea consumption | 52.02 | < 0.001 | ||||||
Never or almost never | 325 | 49.02 | 8061 | 52.78 | 8386 | 52.62 | ||
Only occasionally | 215 | 32.43 | 3197 | 20.93 | 3412 | 21.41 | ||
Most days or almost every day | 123 | 18.55 | 4015 | 26.29 | 4138 | 25.97 | ||
Physical activities | 18.55 | < 0.001 | ||||||
Never or almost never | 606 | 91.40 | 13,133 | 85.99 | 13,739 | 86.21 | ||
1–2 times / week | 9 | 1.36 | 385 | 2.52 | 394 | 2.47 | ||
3–5 times / week | 7 | 1.06 | 338 | 2.21 | 345 | 2.16 | ||
Daily or almost every day | 41 | 6.18 | 1417 | 9.28 | 1458 | 9.15 | ||
Life satisfaction status | 65.40 | < 0.001 | ||||||
Very satisfied | 73 | 11.01 | 3233 | 21.17 | 3306 | 20.75 | ||
Basically satisfied | 482 | 72.70 | 10,610 | 69.47 | 11,092 | 69.60 | ||
General | 103 | 15.54 | 1376 | 9.01 | 1479 | 9.28 | ||
Not satisfied | 5 | 0.75 | 54 | 0.35 | 59 | 0.37 | ||
Self-rated health status | 36.62 | < 0.001 | ||||||
Excellent | 105 | 15.84 | 3467 | 22.70 | 3572 | 22.41 | ||
Good | 434 | 65.46 | 8674 | 56.79 | 9108 | 57.15 | ||
General | 108 | 16.29 | 2989 | 19.57 | 3097 | 19.43 | ||
Fair-poor | 16 | 2.41 | 143 | 0.94 | 159 | 1.00 | ||
BMI (kg/m2) | 11.34 | 0.010 | ||||||
< 18.5 | 14 | 2.11 | 276 | 1.81 | 290 | 1.82 | ||
18.5–25.0 | 409 | 61.69 | 8658 | 56.69 | 9067 | 56.90 | ||
25.0–30.0 | 194 | 29.26 | 5422 | 35.50 | 5616 | 35.24 | ||
≥ 30.0 | 46 | 6.94 | 917 | 6.00 | 963 | 6.04 | ||
Esophageal pathology | 27.54 | < 0.001 | ||||||
Health | 505 | 76.17 | 10,402 | 68.11 | 10,907 | 68.44 | ||
Esophagitis | 121 | 18.25 | 3927 | 25.71 | 4048 | 25.40 | ||
LGIN | 23 | 3.47 | 746 | 4.88 | 769 | 4.83 | ||
HGIN | 9 | 1.36 | 148 | 0.97 | 157 | 0.99 | ||
EC | 5 | 0.75 | 50 | 0.33 | 55 | 0.35 |
Multiple linear regression analysis of depression (PHQ-9 scores) and baseline characteristics
Characteristics | Unstandardized β | Coefficients Std.Error | Standardized β | 95% CI for β | P value | Collinerity Statistics | |
---|---|---|---|---|---|---|---|
Tolerance | VIF | ||||||
Occupation | 0.191 | 0.008 | 0.199 | (0.176, 0.205) | < 0.001 | 0.845 | 1.184 |
Life satisfaction status | −0.151 | 0.008 | −0.150 | (−0.167, −0.135) | < 0.001 | 0.794 | 1.260 |
Region | −0.331 | 0.018 | −0.148 | (−0.366, −0.297) | < 0.001 | 0.852 | 1.173 |
Household income | −0.111 | 0.009 | −0.096 | (−0.128, −0.094) | < 0.001 | 0.934 | 1.071 |
Physical activities | 0.130 | 0.011 | 0.088 | (0.108, 0.152) | < 0.001 | 0.904 | 1.106 |
Self-rated health status | −0.073 | 0.008 | −0.073 | (− 0.088, − 0.057) | < 0.001 | 0.798 | 1.253 |
Tea consumption | 0.027 | 0.007 | 0.031 | (0.013, 0.041) | < 0.001 | 0.781 | 1.280 |
BMI | −0.139 | 0.032 | − 0.031 | (− 0.203, − 0.075) | < 0.001 | 0.982 | 1.018 |
Alcohol consumption | 0.022 | 0.007 | 0.025 | (0.008, 0.036) | 0.002 | 0.825 | 1.213 |
Marital status | −0.030 | 0.012 | −0.018 | (− 0.053, − 0.006) | 0.013 | 0.962 | 1.040 |
Highest education level | 0.012 | 0.006 | 0.015 | (0.000, 0.024) | 0.048 | 0.928 | 1.078 |
The association between depression and the esophageal lesions
Esophageal pathology | Health | Esophagitis OR (95%CI) | LGIN OR (95%CI) | HGIN OR (95%CI) | EC OR (95%CI) |
---|---|---|---|---|---|
Model 1a | Ref | 0.93 (0.92–0.95)** | 0.97 (0.94–0.99)** | 1.05 (1.00–1.10)* | 1.04 (0.97–1.14) |
Model 2b | Ref | 1.01 (0.99–1.03) | 0.97 (0.94–1.01) | 1.04 (0.98–1.11) | 1.08 (0.98–1.19) |
Model 3c | Ref | 1.02 (0.99–1.04) | 0.98 (0.95–1.01) | 1.04 (0.98–1.11) | 1.10 (0.99–1.21) |