Objective To analyze the opportunistic screening results for upper gastrointestinal cancer in Sichuan province from 2019 to 2023, thus providing a reference for promoting opportunistic screening for upper gastrointestinal cancer in this region.

Methods Data were collected from the Early Diagnosis and Treatment Management Platform of the Sichuan Cancer Prevention and Control Center. The study included 844 844 high-risk individuals aged ≥ 40 years who underwent gastroscopy at 88 secondary or higher-level hospitals across 18 cities (prefectures) in five major economic regions (Chengdu Plain Economic Zone, Southern Sichuan Economic Zone, Northeastern Sichuan Economic Zone, Panxi Economic Zone, and Northwestern Sichuan Ecological Demonstration Area) of Sichuan province from July 2019 to May 2023. The biopsy rate, lesion detection rate, and early diagnosis rate of upper gastrointestinal cancer in Sichuan province were analyzed.

Results Among the 844 844 high-risk individuals who underwent opportunistic screening for upper gastrointestinal cancer from 2019 to 2023, 182 133 individuals underwent biopsies, with a total of 190 852 biopsy sites, yielding a biopsy rate of 22.59%. A total of 20 647 cases of lesions were detected, with a lesion detection rate of 2.44%. Among the detected cases, 5 258 were early-stage lesions, resulting in an early diagnosis rate of 25.47%. The esophagus, cardia, and stomach showed the bioscopy rates of 3.80%, 1.09%, and 17.71%, lesion detection rates of 1.37%, 0.29%, and 0.78%, and early diagnosis rates of 28.29%, 20.44%, and 22.37%, respectively. Comparative analysis by demographic characteristics revealed that males had higher biopsy rate and lesion detection rate but lower early diagnosis rate than females (all P < 0.001). Both the biopsy rate and lesion detection rate increased with age, while the early diagnosis rate decreased with age (all P < 0.001). Differences were observed in biopsy rate, lesion detection rate, and early diagnosis rate across different regions (all P < 0.001). Individuals who underwent painless gastroscopy had higher biopsy rate, lesion detection rate, and early diagnosis rate than those who underwent conventional gastroscopy (all P < 0.05). The examination with the use of chemical staining methods resulted in higher biopsy rate, lesion detection rate, and early diagnosis rate than the examination without the use of chemical staining (all P < 0.001). In addition, differences were also observed in biopsy rate, lesion detection rate, and early diagnosis rate among individuals with different Helicobacter pylori test results (all P < 0.05).

Conclusions The biopsy rate, lesion detection rate, and early diagnosis rate in opportunistic screening for upper gastrointestinal cancer in Sichuan province were low from 2019 to 2023. Efforts are still required, with particular attention needed for male and elderly populations.