上消化道癌是我国的高发癌症，筛查是降低其发病率、死亡率的有效手段。2005年起，我国利用“内镜+指示性活检”技术在农村地区开展了上消化道多癌种（食管癌、贲门癌、胃癌）联合筛查，但联合筛查的效果和经济性未得到全面评价，适合不同地区的差异化筛查策略尚未达成共识。本项目依托山东省上消化道癌筛查和早诊早治平台，建立基于多中心的上消化道癌筛查人群回顾性研究队列，以队列数据和现场调查资料为基础，构建我国人群特异性的上消化道多癌种联合筛查Markov模型，模拟和预测不同内镜筛查策略对人群健康的影响，并进行成本-效果（用）分析，从流行病学和卫生经济学角度综合分析各筛查策略的有效性和经济性；从社会视角出发，结合政策背景、筛查意愿、支付意愿等因素，提出针对不同经济发展水平和发病特点的我国农村地区上消化道癌最优内镜筛查策略。预期结果将为提高上消化道癌筛查的效率、效益和进一步推广癌症筛查策略提供重要的科学依据。

Upper gastrointestinal cancer remains an important health problem in China, and screening is an effective means to reduce its morbidity and mortality. China has launched a screening project for upper gastrointestinal cancer in high-risk rural areas in 2005. However, the effectiveness and economics of the multi-cancer joint screening strategy have not been fully evaluated, and the differentiation strategies suitable for different regions have not yet reached consensus. Relying on the Shandong Provincial Cancer Screening and Early Diagnosis, Early Treatment Platform, we establishes a multicenter-based upper gastrointestinal cancer screening population research cohort. Based on the cohort data and field survey data, we constructed a population-specific Markov model of multi-cancer joint screening for upper gastrointestinal cancer to predict the impact of different endoscopic screening strategies on population health, and to conduct a cost-effective (utility) analysis. Then, to analyze the effectiveness and economics of each screening strategy from the perspective of epidemiology and health economics by combing field data and the Markov model’s prediction results. The optimal endoscopic screening strategies for rural areas of different levels of economic development and cancer characteristics will be formulated based on the above results and other factors, such as policy background, screening cognition, willingness to pay, etc. The expected results will provide an important scientific basis for improving the efficiency, effectiveness and further promotion of upper gastrointestinal cancer screening.