Endoscopic Screening for Gastric Cancer: A Cost-utility Analysis for Countries with an Intermediate Gastric Cancer Risk

Overview

Journal United European Gastroenterol J

Publisher Wiley

Specialty Gastroenterology

Date 2018 Mar 8

PMID 29511549

Citations 34

Authors

Miguel Areia

Manon Cw Spaander

Ernst J Kuipers

Mario Dinis-Ribeiro

Affiliations

Soon will be listed here.

Abstract

Background: Endoscopic screening for gastric cancer is debatable in countries with an intermediate risk.

Objective: The objective of this article is to determine the cost-utility of screening strategies for gastric cancer in a European country.

Methods: We conducted a cost-utility analysis using a Markov model comparing three screening strategies versus no screening: stand-alone upper endoscopy, endoscopy combined with a colorectal cancer screening colonoscopy after a positive faecal occult blood test or pepsinogens serologic screening. Clinical data were collected from systematic reviews, costs from published national data and utilities as quality-adjusted life years (QALY). The primary outcome was the incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analyses were performed. The threshold was set at €37,000 (2016 prices).

Results: Upper endoscopy combined with screening colonoscopy (every 10 or 5 years) had an ICER of 15,407/QALY and €30,908/QALY respectively, stand-alone endoscopic screening (every five years) an ICER of €70,693/QALY and pepsinogens screening an ICER of €143,344/QALY. Sensitivity analyses revealed that only endoscopic costs <€75, a provision of only three endoscopies per patient or a gastric cancer risk >25/100,000 would make stand-alone endoscopic screening cost-effective.

Conclusion: Endoscopic gastric cancer screening in Europe can be cost-effective if combined with a screening colonoscopy in countries with a gastric cancer risk ≥10 per 100,000.

Citing Articles

Cost Utility Analysis of National Cancer Screening Program for Gastric Cancer in Korea: A Markov Model Analysis.

Bae S, Lee H, Her E, Lee K, Kim J, Ahn J J Korean Med Sci. 2025; 40(6):e43.

PMID: 39962941 PMC: 11832884. DOI: 10.3346/jkms.2025.40.e43.

Validation of Artificial Intelligence Computer-Aided Detection on Gastric Neoplasm in Upper Gastrointestinal Endoscopy.

Lee H, Chung J, Yun S, Jung S, Yoon Y, Kim J Diagnostics (Basel). 2024; 14(23).

PMID: 39682614 PMC: 11639788. DOI: 10.3390/diagnostics14232706.

Effectiveness of Gastric Cancer Endoscopic Screening in Intermediate-Risk Countries: Protocol for a Systematic Review and Meta-Analysis.

Mourato M, Pratas N, Branco Pereira A, Tare F, Chanca R, Fronteira I JMIR Res Protoc. 2024; 14:e56791.

PMID: 39545590 PMC: 11833270. DOI: 10.2196/56791.

Effectiveness of Risk-Adapted Upper Gastrointestinal Cancer Screening in China: Prospective Cohort Study.

Wang Y, Zhu J, Li H, Wang L, Zhu C, Li X JMIR Public Health Surveill. 2024; 10:e62864.

PMID: 39388714 PMC: 11486449. DOI: 10.2196/62864.

Mortality from upper gastrointestinal tumors in colorectal cancer screening patients.

Zessner-Spitzenberg J, Waldmann E, Rockenbauer L, Penz D, Hinterberger A, Majcher B Endosc Int Open. 2024; 12(7):E916-E923.

PMID: 39055263 PMC: 11272413. DOI: 10.1055/a-2348-9264.

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