Shota Saito1,2,3, Motoi Azumi4,5, Yusuke Muneoka4,6, Katsuhiko Nishino4, Takashi Ishikawa6,7, Yuichi Sato8, Shuji Terai5, Kouhei Akazawa7. 1. Department of Medical Informatics and Statistics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. shota-saito@nuhw.ac.jp. 2. Department of Health Informatics, Niigata University of Health and Welfare, Niigata, Japan. shota-saito@nuhw.ac.jp. 3. Department of Medical Informatics, Niigata University Medical and Dental Hospital, 1-754 Asahimachi, Chuo-ku, Niigata, 951-8520, Japan. shota-saito@nuhw.ac.jp. 4. Department of Medical Informatics and Statistics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. 5. Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. 6. Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. 7. Department of Medical Informatics, Niigata University Medical and Dental Hospital, 1-754 Asahimachi, Chuo-ku, Niigata, 951-8520, Japan. 8. Division of Endoscopy, Niigata University Medical and Dental Hospital, Niigata, Japan.
Abstract
BACKGROUND: A combination of assays for the presence of serum anti-Helicobacter pylori IgG antibody (HPA) and serum pepsinogen (PG) concentrations can be used to screen for gastric cancer risk. In Japan, this "ABC method" is considered an effective means of stratifying gastric cancer risk. This study aimed to ascertain its cost-effectiveness for assessing gastric cancer risk. METHODS: A Markov model was constructed to compare the cost-effectiveness of two strategies for gastric cancer-risk screening over a 30-year period: the ABC method, which uses a combination of assessing the presence of HPA and measuring serum PG concentrations and scheduling endoscopies accordingly, and annual endoscopic screening. Clinical and epidemiological data on variables in the model were obtained from published reports. Analyses were made from the perspective of the Japanese health care payer. RESULTS: According to base-case analysis, the ABC method cost less than annual endoscopic screening (64,489 vs. 64,074 USD) and saved more lives (18.16 vs. 18.30 quality-adjusted life years). One-way analyses confirmed the robustness of the cost-effectiveness results. The probability that the ABC method is cost-effective in Japanese individuals aged 50 years was 0.997. CONCLUSIONS: A combination of HPA and serum PG assays, plus scheduling endoscopy accordingly, is a cost-effective method of screening for gastric cancer risk in Japan.
BACKGROUND: A combination of assays for the presence of serum anti-Helicobacter pylori IgG antibody (HPA) and serum pepsinogen (PG) concentrations can be used to screen for gastric cancer risk. In Japan, this "ABC method" is considered an effective means of stratifying gastric cancer risk. This study aimed to ascertain its cost-effectiveness for assessing gastric cancer risk. METHODS: A Markov model was constructed to compare the cost-effectiveness of two strategies for gastric cancer-risk screening over a 30-year period: the ABC method, which uses a combination of assessing the presence of HPA and measuring serum PG concentrations and scheduling endoscopies accordingly, and annual endoscopic screening. Clinical and epidemiological data on variables in the model were obtained from published reports. Analyses were made from the perspective of the Japanese health care payer. RESULTS: According to base-case analysis, the ABC method cost less than annual endoscopic screening (64,489 vs. 64,074 USD) and saved more lives (18.16 vs. 18.30 quality-adjusted life years). One-way analyses confirmed the robustness of the cost-effectiveness results. The probability that the ABC method is cost-effective in Japanese individuals aged 50 years was 0.997. CONCLUSIONS: A combination of HPA and serum PG assays, plus scheduling endoscopy accordingly, is a cost-effective method of screening for gastric cancer risk in Japan.
Authors: H Watabe; T Mitsushima; Y Yamaji; M Okamoto; R Wada; T Kokubo; H Doi; H Yoshida; T Kawabe; M Omata Journal: Gut Date: 2005-06 Impact factor: 23.059
Authors: Kryssia Rodriguez; Marilisa Franceschi; Antonio Ferronato; Lorenzo Brozzi; Antonio Antico; Maria Piera Panozzo; Arianna Massella; Barbara Pertoldi; Alice Morini; Alberto Barchi; Michele Russo; Pellegrino Crafa; Lorella Franzoni; Lucio Cuoco; Gianluca Baldassarre; Francesco Di Mario Journal: Acta Biomed Date: 2022-08-31