Abstract: Objective To analyze the detection rate of esophageal cancer and its precancerous lesions within an asymptomatic health check-up population aged ≥40 years in Qingdao, and to investigate the associated risk factors. Methods This study enrolled individuals aged ≥40 years undergoing health examinations at the Qingdao Municipal Central Hospital of Kangfu University from October 2023 to November 2024. Participants were screened using endoscopy combined with histopathological biopsy and completed a structured questionnaire. Descriptive statistics were employed to analyze the detection rates of esophageal cancer and precancerous lesions. Univariate and multivariate logistic regression analyses were conducted to identify associated risk factors. Results A total of 14 958 individuals were screened. Pathological abnormalities were identified in 536 cases, corresponding to an overall detection rate of 3.58%. Among these, esophageal cancer was diagnosed in 2 cases (0.01%), low-grade intraepithelial neoplasia (LGIN) in 421 cases (2.81%), and high-grade intraepithelial neoplasia (HGIN) in 113 cases (0.76%). Multivariate logistic regression analysis indicated that male gender (OR=2.109), advanced age (OR=1.645), history of alcohol consumption (OR=2.309), frequent consumption of pickled foods (OR=2.315), frequent consumption of excessively hot foods or beverages (OR=3.466), a history of digestive system diseases (OR=2.205), a family history of esophageal cancer (OR=3.564), and occupational exposure (OR=2.868) were significant risk factors for esophageal cancer and precancerous lesions in this population. Conclusions The prevalence of esophageal cancer among the asymptomatic population aged ≥40 years in Qingdao is low. However, the substantial proportion of LGIN and HGIN highlights a significant at-risk population that warrants attention. Male gender, advanced age, alcohol consumption, frequent intake of pickled and excessively hot foods, a history of digestive diseases, a family history of esophageal cancer, and occupational exposure are key determinants for the development of esophageal cancer and its precursor lesions.

Key words: Health examination, Esophageal cancer, Precancerous lesions, Risk factors