BACKGROUND & AIMS: Population endoscopic screening for gastric cancer is generally deemed not to be cost-effective except in Japan, where its prevalence is very high. However, in the absence of screening, patients present with advanced disease, and prognosis is poor. We conducted a cost utility analysis to determine whether endoscopic screening for stomach cancer in intermediate-risk population would be cost-effective and to better define the high-risk groups in the population who would benefit from such strategy. METHODS: Cost-effectiveness analysis was performed by using a Markov Model. Simulation was performed on Singapore (intermediate-risk) population and various high-risk subgroups. Comparison was made between 2-yearly endoscopic mass screening program versus no screening. Data sources were extracted from relevant studies published from 1980-2004 identified via systematic PUBMED search. Main outcome measures were deaths caused by stomach cancer averted, cost per life saved, and incremental cost-effectiveness ratio expressed as cost per quality-adjusted life year (QALY) saved. RESULTS: Screening of high-risk group of Chinese men (age-standardized rate, 25.9/100,000) from 50-70 years old is highly cost-effective, with cost benefit of United States $26,836 per QALY. Screening this cohort of 199,000 subjects prevents 743 stomach cancer deaths and saves 8234 absolute life years. Cost of averting 1 cancer death is United States $247,600. Cost-effectiveness was most sensitive to incidence of stomach cancer and cost of screening endoscopy. CONCLUSIONS: Screening of stomach cancer in moderate to high-risk population subgroups is cost-effective. Targeted screening strategies for stomach cancer should be explored.
BACKGROUND & AIMS: Population endoscopic screening for gastric cancer is generally deemed not to be cost-effective except in Japan, where its prevalence is very high. However, in the absence of screening, patients present with advanced disease, and prognosis is poor. We conducted a cost utility analysis to determine whether endoscopic screening for stomach cancer in intermediate-risk population would be cost-effective and to better define the high-risk groups in the population who would benefit from such strategy. METHODS: Cost-effectiveness analysis was performed by using a Markov Model. Simulation was performed on Singapore (intermediate-risk) population and various high-risk subgroups. Comparison was made between 2-yearly endoscopic mass screening program versus no screening. Data sources were extracted from relevant studies published from 1980-2004 identified via systematic PUBMED search. Main outcome measures were deaths caused by stomach cancer averted, cost per life saved, and incremental cost-effectiveness ratio expressed as cost per quality-adjusted life year (QALY) saved. RESULTS: Screening of high-risk group of Chinese men (age-standardized rate, 25.9/100,000) from 50-70 years old is highly cost-effective, with cost benefit of United States $26,836 per QALY. Screening this cohort of 199,000 subjects prevents 743 stomach cancer deaths and saves 8234 absolute life years. Cost of averting 1 cancer death is United States $247,600. Cost-effectiveness was most sensitive to incidence of stomach cancer and cost of screening endoscopy. CONCLUSIONS: Screening of stomach cancer in moderate to high-risk population subgroups is cost-effective. Targeted screening strategies for stomach cancer should be explored.
Authors: Jovanny Zabaleta; Maria C Camargo; Marylyn D Ritchie; Maria B Piazuelo; Rosa A Sierra; Stephen D Turner; Alberto Delgado; Elizabeth T H Fontham; Barbara G Schneider; Pelayo Correa; Augusto C Ochoa Journal: Int J Cancer Date: 2011-02-01 Impact factor: 7.396
Authors: Bradley W Anderson; Yun-Suhk Suh; Boram Choi; Hyuk-Joon Lee; Tracy C Yab; William R Taylor; Brian A Dukek; Calise K Berger; Xiaoming Cao; Patrick H Foote; Mary E Devens; Lisa A Boardman; John B Kisiel; Douglas W Mahoney; Seth W Slettedahl; Hatim T Allawi; Graham P Lidgard; Thomas C Smyrk; Han-Kwang Yang; David A Ahlquist Journal: Clin Cancer Res Date: 2018-05-29 Impact factor: 12.531
Authors: Woon Geon Shin; Heung Up Kim; Ho June Song; Su Jin Hong; Ki-Nam Shim; In-Kyung Sung; Jae Gyu Kim Journal: Dig Dis Sci Date: 2011-10-08 Impact factor: 3.199
Authors: Min Jung Park; Dong Hee Kim; Seon Hee Lim; Jeong Yoon Yim; Young Sun Kim; Kyung Ran Cho; Chung Hyeon Kim; Hyun Chae Jung; In Sung Song; Sun Sin Kim; Dae Hyun Yoon; Chan Soo Shin; Sang-Heon Cho; Byung-Hee Oh; Dong Ho Lee Journal: Gut Liver Date: 2007-06-30 Impact factor: 4.519