Screening for gastric cancer and surveillance of premalignant lesions: a systematic review of cost-effectiveness studies
- PMID: 23566268
- DOI: 10.1111/hel.12050
Screening for gastric cancer and surveillance of premalignant lesions: a systematic review of cost-effectiveness studies
Abstract
Background: Cost-effectiveness studies are highly dependent on the models, settings, and variables used and should be based on systematic reviews. We systematically reviewed cost-effectiveness studies that address screening for gastric cancer and/or surveillance of precancerous conditions and lesions.
Materials and methods: A systematic review of cost-effectiveness studies was performed by conducting a sensitive search in seven databases (PubMed, Scopus, Web of Science, Current Contents Connect, Centre for Reviews and Dissemination, Academic Search Complete, and CINAHL Plus), independently evaluated by two investigators. Articles were evaluated for type of study, perspective, model, intervention, incremental cost-effectiveness ratio, clinical or cost variables, and quality, according to published guidelines.
Results: From 2395 abstracts, 23 articles were included: 19 concerning population screening and 4 on following up premalignant lesions. Studies on Helicobacter pylori screening concluded that serology was cost-effective, depending on cancer incidence and endoscopy cost (incremental cost-effectiveness ratio: 6264-25,881), and eradication after endoscopic resection was also cost-effective (dominant) based on one study. Studies on imaging screening concluded that endoscopy was more cost-effective than no screening (incremental cost-effectiveness ratio: 3376-26,836). Articles on follow-up of premalignant lesions reported conflicting results (incremental cost-effectiveness ratio: 1868-72,519 for intestinal metaplasia; 18,600-39,800 for dysplasia). Quality assessment revealed a unanimous lack of a detailed systematic review and fulfillment of a median number of 23 items (20-26) of 35 possible ones.
Conclusions: The available evidence shows that Helicobacter pylori serology or endoscopic population screening is cost-effective, while endoscopic surveillance of premalignant gastric lesions presents conflicting results. Better implementation of published guidelines and accomplishment of systematic detailed reviews are needed.
Keywords: Atrophic gastritis; Helicobacter pylori; Review; cost-effectiveness; costs and benefits; early detection of cancer; gastric cancer; gastric neoplasm; gastrointestinal endoscopy; intestinal metaplasia; stomach neoplasm.
© 2013 John Wiley & Sons Ltd.
Similar articles
-
Cost-effectiveness of Helicobacter pylori test and eradication versus upper gastrointestinal series versus endoscopy for gastric cancer mortality and outcomes in high prevalence countries.Scand J Gastroenterol. 2019 Jun;54(6):685-689. doi: 10.1080/00365521.2019.1627408. Epub 2019 Jun 13. Scand J Gastroenterol. 2019. PMID: 31190581
-
Cost effectiveness analysis of population-based serology screening and (13)C-Urea breath test for Helicobacter pylori to prevent gastric cancer: a markov model.World J Gastroenterol. 2008 May 21;14(19):3021-7. doi: 10.3748/wjg.14.3021. World J Gastroenterol. 2008. PMID: 18494053 Free PMC article.
-
Cost-Effectiveness of Screening Helicobacter pylori for Gastric Cancer Prevention: a Systematic Review.J Gastrointest Cancer. 2022 Dec;53(4):1093-1103. doi: 10.1007/s12029-021-00726-7. Epub 2021 Oct 25. J Gastrointest Cancer. 2022. PMID: 34694594 Review.
-
Endoscopy Is Cost-Effective for Gastric Cancer Screening After Successful Helicobacter pylori Eradication.Dig Dis Sci. 2021 Dec;66(12):4220-4226. doi: 10.1007/s10620-020-06813-2. Epub 2021 Jan 8. Dig Dis Sci. 2021. PMID: 33417196
-
Screening of gastric cancer: who, when, and how.Clin Gastroenterol Hepatol. 2014 Jan;12(1):135-8. doi: 10.1016/j.cgh.2013.09.064. Epub 2013 Oct 6. Clin Gastroenterol Hepatol. 2014. PMID: 24107396 Review.
Cited by
-
Trends of gastric cancer burdens attributable to risk factors in China from 2000 to 2050.Lancet Reg Health West Pac. 2024 Jan 6;44:101003. doi: 10.1016/j.lanwpc.2023.101003. eCollection 2024 Mar. Lancet Reg Health West Pac. 2024. PMID: 38269331 Free PMC article.
-
Global burden of gastric cancer: epidemiological trends, risk factors, screening and prevention.Nat Rev Clin Oncol. 2023 May;20(5):338-349. doi: 10.1038/s41571-023-00747-0. Epub 2023 Mar 23. Nat Rev Clin Oncol. 2023. PMID: 36959359 Review.
-
Gastroscopy after positive screening for faecal immunochemical tests and colonoscopy: A systematic review.PLoS One. 2023 Feb 10;18(2):e0281557. doi: 10.1371/journal.pone.0281557. eCollection 2023. PLoS One. 2023. PMID: 36763684 Free PMC article.
-
Ornithine Decarboxylase in Gastric Epithelial Cells Promotes the Immunopathogenesis of Helicobacter pylori Infection.J Immunol. 2022 Aug 15;209(4):796-805. doi: 10.4049/jimmunol.2100795. Epub 2022 Jul 27. J Immunol. 2022. PMID: 35896340 Free PMC article.
-
Underlying mechanisms of change in cancer prevalence in older U.S. adults: contributions of incidence, survival, and ascertainment at early stages.Cancer Causes Control. 2022 Sep;33(9):1161-1172. doi: 10.1007/s10552-022-01595-6. Epub 2022 Jul 7. Cancer Causes Control. 2022. PMID: 35799033 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical