International cost-effectiveness analysis evaluating endoscopic screening for gastric cancer for populations with low and high risk

Abstract

Background Gastric cancer remains one of the 3 most common causes of cancer death worldwide. Understanding the health and economic factors that affect screening cost-effectiveness in different countries will help address when and where it makes most sense to screen for gastric cancer. Methods We performed a cost-effectiveness analysis using a Markov model to compare screening and surveillance strategies for gastric cancer in Brazil, France, Japan, Nigeria, and the United States. Primary outcome was the incremental costeffectiveness ratio. We then performed a sensitivity analysis to determine how each variable affected the overall model. Results In all countries, the most cost-effective strategies, measured by incremental cost-effectiveness ratio relative to no screening, were screening every 10 years, surveillance of high-and low-risk patients every 5 and 10 years, respectively, and screening every 5 years. Only Japan had at least one cost-effective screening strategy. The most important variables across different screening strategies and countries were starting age of screening, cost of endoscopy, and baseline probability of local gastric cancer at time of diagnosis. Conclusions Our model suggests that screening for gastric cancer is cost-effective in countries with higher incidence and lower costs of screening, but screening may still be a viable option in high-risk populations within low incidence countries.

Promising Advances in LINC01116 Related to Cancer

“…Gastric cancer is the 4th most prevalent malignant tumor. Due to the lack of early diagnostic markers, patients are commonly diagnosed at terminal stages, with tumors that have metastasized to proximal or even remote regions in the body ( Lin et al, 2019 ; Arnold et al, 2020 ; Ascherman et al, 2021 ; Puliga et al, 2021 ). Su et al (2019) discovered that LINC01116 and CASC11 were upregulated in GC tissues, compared with cancer-adjacent tissues, and were positively correlated with clinical stages.…”

Do Patient Delay and Diagnostic Delay Influence Long Term Survival in Patients with Gastric Cancer?

“…Screening of high-risk populations has been proved to increase the diag diagnosis of early-gastric cancer and to improve long-term survival [13,14]. However, in European countries, there is no designated screening program for gastric cancer [15,16]. Therefore, diagnosing early gastric cancer, in the asymptomatic period, is the exception and not the rule [17][18][19].…”

A Population-Based Helicobacter pylori Eradication Strategy Is More Cost-Effective than Endoscopic Screening

“…Our study also showed that biennial endoscopic screening is not cost-effective for asymptomatic Japanese population aged 50 years. Ascherman et al showed that biennial endoscopic screening is not cost-effective, while 5-year and 10-year endoscopic screening is cost-effective compared to no screening in the general Japanese population aged 40 years through 35 successive 1-year cycles of the model until age 75 [ 41 ]. Our study also demonstrated that endoscopic screening at the 1-year, 2-year, and 3-year intervals is not cost-effective in the Japanese population aged 40 years.…”