Cost–benefit analysis of Helicobacter pylori screening

Leivo, Tiina; Salomaa, Anniina; Kosunen, Timo U.; Tuominen, Raimo K.; Färkkilä, Martti; Linna, Miika; Sintonen, Harri

doi:10.1016/j.healthpol.2004.02.004

Cited by 15 publications

(21 citation statements)

References 42 publications

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“…Most of these studies compared strategies of screening for and treating H. pylori versus no screening from the public healthcare provider's perspective, used estimates from systematic reviews of the literature, and conducted sensitivity analyses with results that were consistent in most strategies. Despite involving populations with very different gastric cancer risks and also the use of diverse models, all studies concluded that the screening option is cost-effective compared with no screening [258][259][260][261][262][263][264][265][266][267][268][269][270].…”

Section: Surveillancementioning

confidence: 99%

Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)

et al. 2011

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Atrophic gastritis, intestinal metaplasia, and epithelial dysplasia of the stomach are common and are associated with an increased risk for gastric cancer. In the absence of guidelines, there is wide disparity in the management of patients with these premalignant conditions. The European Society of Gastrointestinal Endoscopy, the European Helicobacter Study Group, the European Society of Pathology, and the Sociedade Portuguesa de Endoscopia Digestiva have therefore combined efforts to develop evidence-based guidelines on the management of patients with precancerous conditions and lesions of the stomach. A multidisciplinary group of 63 experts from 24 countries developed these recommendations by means of repeat online voting and a meeting in June 2011 in Porto, Portugal. The recommendations emphasize the increased cancer risk in patients with gastric atrophy and metaplasia and the need for adequate staging in the case of high-grade dysplasia, and they focus on treatment and surveillance indications and methods.

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Section: Surveillancementioning

confidence: 99%

Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)

et al. 2011

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“…The comparator was no screening or treatment. Seven studies evaluated the cost-effectiveness of screening based on serology testing [26–33, 36, 37, 39], one study considered screening using C-UBT [6], and two studies compared both methodologies (one of which also considered SAT)[34, 35, 38]. Seven studies considered screening in both sexes (with some reporting results for males and females separately), two evaluated screening in men only, and one assessed screening of both sexes in one ethnic group and in males only in other ethnic groups.…”

Section: Cost-effectiveness Of Screening For H Pylori In the Generalmentioning

confidence: 99%

“…Six studies reported findings for low H. pylori prevalence countries – the USA, UK, Canada and Finland [26–33, 38]. Prevalence of H. pylori infection was generally assumed to be 27–40% with Leivo et al [33], in their study in Finland, assuming considerably lower prevalence (13%).…”

Section: Cost-effectiveness Of Screening For H Pylori In the Generalmentioning

confidence: 99%

Cost-effectiveness of screening and treating Helicobacter pylori for gastric cancer prevention

Lansdorp–Vogelaar

Sharp

2013

Best Practice & Research Clinical Gastroenterology

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Gastric cancer is second leading cause of cancer-related death worldwide. A meta-analysis of seven randomized controlled trials concluded that H. Pylori eradication reduces gastric cancer incidence by 35%. Current consensus is that H. Pylori screening and treatment is cost-effective only in high-risk populations. This paper provides an up-to-date overview of the evidence for cost-effectiveness of H. Pylori screening and treatment in different population settings and risk levels for H. Pylori infection. Ten unique cost-effectiveness or cost-utility analyses were identified. All found that screening for H. Pylori to prevent gastric cancer in the general population costs less than $50,000 per LYG. This finding was robust for differences in H. Pylori prevalence, gender and ethnicity. Based on limited evidence, re-treatment (for treatment failure), repeated screening, limiting screening and treatment to those with the CagA phenotype, or universal treatment, does not appear to be cost-effective. However, most included studies failed to consider both the broader benefits as well as the adverse effects of widespread use of antibiotics for H. Pylori.

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“…The total cost to screen for H. pylori was significantly favorable when compared with what it would cost once diagnosed with gastric cancer. In patients 45 years and older, H. pylori screening and cost-benefit ratio was the greatest, favoring most cost savings per case (Leivo et al, 2004). Similarly, early H. pylori screening, testing, and eradication therapy once in a lifetime seem more cost-effective than does surveillance; however, the choice is still confounded by variables such as infection risk, detection of early carcinoma, and intervention timing (Lee et al, 2007).…”

Section: Clinical Implications For the Nurse Practitioner And Nurse Cmentioning

confidence: 99%

Care of Older Adult Populations Diagnosed With Helicobacter pylori

Fromm¹

2009

Gastroenterology Nursing

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Helicobacter pylori has been linked to development of peptic ulcers and increases the risk of developing gastric carcinoma. Currently, about half of the world's population is infected with H. pylori, many of whom are older adults. Older adult populations often have multiple comorbidities that may mask dyspeptic signs and symptoms. The role of H. pylori and infective signs vary by age, and the confusing symptoms in older adult populations may delay detection and treatment of H. pylori. In addition, time of detection and appropriate treatment is paramount to prevent gastric pathology. Clinicians need to recognize and understand the importance of risk factors, screening, detection, and treatment of H. pylori, particularly in older adults. Earlier detection and more aggressive, proactive clinical recognition of dyspeptic signs and symptoms may lead to earlier screening and diagnosis of H. pylori in older adult populations and help decrease the frequency of gastric metaplasia.

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Cost–benefit analysis of Helicobacter pylori screening

Cited by 15 publications

References 42 publications

Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)

Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)

Cost-effectiveness of screening and treating Helicobacter pylori for gastric cancer prevention

Care of Older Adult Populations Diagnosed With Helicobacter pylori

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