Endoscopy for Gastric Cancer Screening Is Cost Effective for Asian Americans in the United States

Shah, Shailja C.; Canakis, Andrew; Peek, Richard M.; Saumoy, Monica

doi:10.1016/j.cgh.2020.07.031

Cited by 49 publications

(23 citation statements)

References 48 publications

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“…certain race or ethnic groups in low-risk countries could be cost-effective. 42 , 43 Two of the countries with the highest incidence rates globally, yet considerably lower mortality are Japan and the Republic of Korea. In 1953, gastric cancer screening using an indirect X-ray truck was started in Japan, and the number of people receiving screening increased rapidly with introduction of the Health Care Law for the Elderly in 1982.…”

Section: Discussionmentioning

confidence: 99%

The current and future incidence and mortality of gastric cancer in 185 countries, 2020–40: A population-based modelling study

et al. 2022

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Section: Discussionmentioning

confidence: 99%

The current and future incidence and mortality of gastric cancer in 185 countries, 2020–40: A population-based modelling study

et al. 2022

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“…For example, various testing methods have different advantages and disadvantages 418 and the availability of accurate and affordable diagnostic tests may vary according to different settings. 419 The choice of the regimen would require local data on the efficacy, adverse effects and costs to optimise the performance of the programme. Follow-up of the treatment to confirm eradication success should be incorporated and needs to be evaluated based on feasibility and cost-effectiveness at the regional level.…”

Section: Agreement 100%mentioning

confidence: 99%

“…Accurate H. pylori detection, high efficacy of the eradication regimen and monitoring of the eradication success are among the key requirements to determine successful implementation of the programmes, however each choice requires the incorporation of local considerations. For example, various testing methods have different advantages and disadvantages418 and the availability of accurate and affordable diagnostic tests may vary according to different settings 419. The choice of the regimen would require local data on the efficacy, adverse effects and costs to optimise the performance of the programme.…”

Section: Wg 4: Gastric Cancer and Preventionmentioning

confidence: 99%

Management ofHelicobacter pyloriinfection: the Maastricht VI/Florence consensus report

Malfertheiner

Mégraud

Rokkas

et al. 2022

Gut

700

842

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Helicobacter pyloriInfection is formally recognised as an infectious disease, an entity that is now included in the International Classification of Diseases 11th Revision. This in principle leads to the recommendation that all infected patients should receive treatment. In the context of the wide clinical spectrum associated with Helicobacter pylori gastritis, specific issues persist and require regular updates for optimised management.The identification of distinct clinical scenarios, proper testing and adoption of effective strategies for prevention of gastric cancer and other complications are addressed. H. pylori treatment is challenged by the continuously rising antibiotic resistance and demands for susceptibility testing with consideration of novel molecular technologies and careful selection of first line and rescue therapies. The role of H. pylori and antibiotic therapies and their impact on the gut microbiota are also considered.Progress made in the management of H. pylori infection is covered in the present sixth edition of the Maastricht/Florence 2021 Consensus Report, key aspects related to the clinical role of H. pylori infection were re-evaluated and updated. Forty-one experts from 29 countries representing a global community, examined the new data related to H. pylori infection in five working groups: (1) indications/associations, (2) diagnosis, (3) treatment, (4) prevention/gastric cancer and (5) H. pylori and the gut microbiota. The results of the individual working groups were presented for a final consensus voting that included all participants. Recommendations are provided on the basis of the best available evidence and relevance to the management of H. pylori infection in various clinical fields.

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“…[11][12][13] In the US, due to low overall prevalence of GIM, surveillance has not been shown to be effective in preventing cancer, although some subgroups of the population may benefit. [13][14][15] GIM is often detected incidentally from biopsies during esophagogastroduodenoscopy (EGD) performed for common symptoms. Incidence, prevalence, and outcomes data are limited in the US due to an inability to accurately identify patients with GIM in the electronic medical records (EMRs).…”

Section: Introductionmentioning

confidence: 99%

Index diagnoses of gastric intestinal metaplasia in the United States: patient characteristics, endoscopic findings, and clinical practice patterns at a large tertiary care center

Parbhu

Shah

Sossenheimer

et al. 2022

Therap Adv Gastroenterol

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Background: Gastric intestinal metaplasia (GIM) is a premalignant gastric mucosal change that is often incidentally detected during esophagogastroduodenoscopy (EGD). Despite the established higher risk of gastric cancer associated with GIM, the incidence, prevalence, and outcomes data for GIM are limited in the United States (US), and practice patterns are highly variable. Objectives: Our primary objectives were to accurately identify incident histology-confirmed GIM cases and determine patient characteristics, endoscopy findings, Helicobacter pylori (HP) detection, and eradication treatment outcomes, as well as surveillance and follow-up recommendations. Design: We conducted a retrospective cohort study using administrative data. Methods: We first developed and validated a rule-based natural language processing tool to identify the patients with GIM on gastrointestinal pathology reports between 2011 and 2016. We then performed a manual chart review of all EGD procedures and associated pathology notes to confirm cases and obtain clinically relevant data. Results: In all, 414 patients with an index diagnosis of GIM were confirmed (prevalence = 2.5% of patients undergoing any EGD). A majority (52.4%) of patients were non-Hispanic white. The most common indication for EGD was abdominal pain (46.9%). A majority (55%) did not receive specific follow-up recommendations or were asked to see their primary care provider. HP testing was documented in 86% of patients, and detected in 94 patients (prevalence = 26.4%). Treatment was documented in 94.7% of cases, and eradication confirmed in only 34.8% of these cases. Conclusion: A large group of US patients with an index diagnosis of GIM was accurately identified. There was wide variability in clinical practice patterns including biopsy practice, HP treatment and eradication confirmation testing, and surveillance recommendations. This work demonstrates that there is a major unmet need for quality improvement efforts to standardize care for patients with GIM, a premalignant condition, and inform future prospective studies in a US population.

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Endoscopy for Gastric Cancer Screening Is Cost Effective for Asian Americans in the United States

Cited by 49 publications

References 48 publications

The current and future incidence and mortality of gastric cancer in 185 countries, 2020–40: A population-based modelling study

The current and future incidence and mortality of gastric cancer in 185 countries, 2020–40: A population-based modelling study

Management ofHelicobacter pyloriinfection: the Maastricht VI/Florence consensus report

Index diagnoses of gastric intestinal metaplasia in the United States: patient characteristics, endoscopic findings, and clinical practice patterns at a large tertiary care center

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