Health economics evaluation of gastric cancer prevention and screening: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

QIN Shuxia ¹ , YI Lidan ¹ , LI Sini ^2,3 , WU Meiyu ¹ , WANG Liting ¹ , ZENG Xiaohui ⁴ , TAN Chongqing ¹ , PENG Liubao ¹ ,  WAN Xiaomin ¹

1. Department of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha 410011, P. R. China;
2. Xiangya Nursing School, Central South University, Changsha 410013, P. R. China;
3. School of Health and Related Research, Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield S1 2LB, United Kingdom;
4. PET CT Center, the Second Xiangya Hospital of Central South University, Changsha 410011, P. R. China;

Corresponding author：

WAN Xiaomin, Email: wanxiaomin@csu.edu.cn

Keywords：

Stomach cancer; Screening; Health economics; Systematic review

DOI：

10.7507/1672-2531.202201007

Video：

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Objective To systematically review the current situation of health economics evaluation of gastric cancer screening. Methods The PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect the health economics evaluation studies on gastric cancer screening from January 1^st, 1975 to September 30^th, 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Then, qualitative analysis was performed. Results A total of 44 studies were included. Most of the targeted populations of the study were high-risk groups in areas with a high incidence of gastric cancer. Screening methods such as endoscopy and Helicobacter pylori infection detection were mainly evaluated in those studies. According to the results, about 47% of the studies evaluated a single screening method. A total of 35 studies showed that they established models, however, only a few calibrated the models. Conclusion Most studies of gastric cancer screening reviews neither calibrate the results nor consider the effect of smoking on the progression of gastric cancer. Those evaluated screening programs are limited.

Citation： QIN Shuxia, YI Lidan, LI Sini, WU Meiyu, WANG Liting, ZENG Xiaohui, TAN Chongqing, PENG Liubao, WAN Xiaomin. Health economics evaluation of gastric cancer prevention and screening: a systematic review. Chinese Journal of Evidence-Based Medicine, 2022, 22(7): 812-821. doi: 10.7507/1672-2531.202201007 Copy

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1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. International Agency for Research on Cancer. Global cancer observatory: cancer today, 2021-09-24. Available at: https://gco.iarc.fr/today..
3. 刘宗超, 李哲轩, 张阳, 等. 2020全球癌症统计报告解读. 肿瘤综合治疗电子杂志, 2021, 7(2): 1-13.
4. Katai H, Ishikawa T, Akazawa K, et al. Five-year survival analysis of surgically resected gastric cancer cases in Japan: a retrospective analysis of more than 100 000 patients from the nationwide registry of the Japanese Gastric Cancer Association (2001-2007). Gastric Cancer, 2018, 21(1): 144-154.
5. Spratt JS. The primary and secondary prevention of cancer. J Surg Oncol, 1981, 18(3): 219-230.
6. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Schistosomes, liver flukes and Helicobacter pylori. IARC Monogr Eval Carcinog Risks Hum, 1994, 61: 1-241.
7. Guo Y, Li ZX, Zhang JY, et al. Association between lifestyle factors, vitamin and garlic supplementation, and gastric cancer outcomes: a secondary analysis of a randomized clinical trial. JAMA Netw Open, 2020, 3(6): e206628.
8. Asaka M, Sugiyama T, Nobuta A, et al. Atrophic gastritis and intestinal metaplasia in Japan: results of a large multicenter study. Helicobacter, 2001, 6(4): 294-299.
9. Zhou L, Lin S, Ding S, et al. Relationship of Helicobacter pylori eradication with gastric cancer and gastric mucosal histological changes: a 10-year follow-up study. Chin Med J (Engl), 2014, 127(8): 1454-1458.
10. Hojo M, Miwa H, Ohkusa T, et al. Alteration of histological gastritis after cure of Helicobacter pylori infection. Aliment Pharmacol Ther, 2002, 16(11): 1923-1932.
11. Liou JM, Malfertheiner P, Lee YC, et al. Screening and eradication of Helicobacter pylori for gastric cancer prevention: the Taipei global consensus. Gut, 2020, 69(12): 2093-2112.
12. Chen R, Liu Y, Song G, et al. Effectiveness of one-time endoscopic screening programme in prevention of upper gastrointestinal cancer in China: a multicentre population-based cohort study. Gut, 2021, 70(2): 251-260.
13. Hamashima C, Ogoshi K, Okamoto M, et al. A community-based, case-control study evaluating mortality reduction from gastric cancer by endoscopic screening in Japan. PLoS One, 2013, 8(11): e79088.
14. Jun JK, Choi KS, Lee HY, et al. Effectiveness of the Korean National Cancer Screening Program in Reducing Gastric Cancer Mortality. Gastroenterology, 2017, 152(6): 1319-1328.
15. Drummond M, Sculpher M, Claxton K, et al. Methods for the economic evaluation of health care programmes (4th ed). Oxford: Oxford University Press, 2015.
16. Parsonnet J, Harris RA, Hack HM, et al. Modelling cost-effectiveness of Helicobacter pylori screening to prevent gastric cancer: a mandate for clinical trials. Lancet, 1996, 348(9021): 150-154.
17. Leivo T, Salomaa A, Kosunen TU, et al. Cost-benefit analysis of Helicobacter pylori screening. Health Policy, 2004, 70(1): 85-96.
18. Yeh JM, Kuntz KM, Ezzati M, et al. Exploring the cost-effectiveness of Helicobacter pylori screening to prevent gastric cancer in China in anticipation of clinical trial results. Int J Cancer, 2009, 124(1): 157-166.
19. Kowada A. Cost-effectiveness of Helicobacter pylori screening followed by eradication treatment for employees in Japan. Epidemiol Infect, 2018, 146(14): 1834-1840.
20. Fendrick AM, Chernew ME, Hirth RA, et al. Clinical and economic effects of population-based Helicobacter pylori screening to prevent gastric cancer. Arch Intern Med, 1999, 159(2): 142-148.
21. Harris RA, Owens DK, Witherell H, et al. Helicobacter pylori and gastric cancer: what are the benefits of screening only for the CagA phenotype of H. pylori? Helicobacter, 1999, 4(2): 69-76.
22. 李存艳, 张开金. 芬兰幽门螺旋杆菌筛查成本-效益分析. 国外医学(卫生经济分册), 2007, (4): 184-191.
23. 王倩, 林果为, 金丕焕, 等. 筛查幽门螺杆菌预防胃癌的Markov模型卫生经济学评价. 中华流行病学杂志, 2003, (2): 57-61.
24. Davies R, Crabbe D, Roderick P, et al. A simulation to evaluate screening for Helicobacter pylori infection in the prevention of peptic ulcers and gastric cancers. Health Care Manag Sci, 2002, 5(4): 249-258.
25. Mason J, Axon AT, Forman D, et al. The cost-effectiveness of population Helicobacter pylori screening and treatment: a Markov model using economic data from a randomized controlled trial. Aliment Pharmacol Ther, 2002, 16(3): 559-568.
26. Chen Q, Liang X, Long X, et al. Cost-effectiveness analysis of screen-and-treat strategy in asymptomatic Chinese for preventing Helicobacter pylori-associated diseases. Helicobacter, 2019, 24(2): e12563.
27. Høgh MB, Kronborg C, Hansen JM, et al. The cost effectiveness of Helicobacter pylori population screening-economic evaluation alongside a randomised controlled trial with 13-year follow-up. Aliment Pharmacol Ther, 2019, 49(8): 1013-1025.
28. Han Y, Yan T, Ma H, et al. Cost-effectiveness analysis of helicobacter pylori eradication therapy for prevention of gastric cancer: a Markov model. Dig Dis Sci, 2020, 65(6): 1679-1688.
29. Roderick P, Davies R, Raftery J, et al. Cost-effectiveness of population screening for Helicobacter pylori in preventing gastric cancer and peptic ulcer disease, using simulation. J Med Screen, 2003, 10(3): 148-156.
30. 陈琦, 方颖, 梁晓, 等. 中国自然人群筛查与伺机性检测策略预防幽门螺杆菌相关疾病的卫生经济学评价. 中华消化杂志, 2021, 41(4): 234-240.
31. Lee YC, Lin JT, Wu HM, et al. Cost-effectiveness analysis between primary and secondary preventive strategies for gastric cancer. Cancer Epidemiol Biomarkers Prev, 2007, 16(5): 875-885.
32. Xie F, Luo N, Lee HP. 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, 14(19): 3021-3027.
33. Xie F, Luo N, Blackhouse G, et al. Cost-effectiveness analysis of Helicobacter pylori screening in prevention of gastric cancer in Chinese. Int J Technol Assess Health Care, 2008, 24(1): 87-95.
34. Xie F, O'Reilly D, Ferrusi IL, et al. Illustrating economic evaluation of diagnostic technologies: comparing Helicobacter pylori screening strategies in prevention of gastric cancer in Canada. J Am Coll Radiol, 2009, 6(5): 317-323.
35. Schulz TR, McBryde ES, Leder K, et al. Using stool antigen to screen for Helicobacter pylori in immigrants and refugees from high prevalence countries is relatively cost effective in reducing the burden of gastric cancer and peptic ulceration. PLoS One, 2014, 9(9): e108610.
36. Teng AM, Kvizhinadze G, Nair N, et al. A screening program to test and treat for Helicobacter pylori infection: Cost-utility analysis by age, sex and ethnicity. BMC Infect Dis, 2017, 17(1): 156.
37. Kowada A. 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, 54(6): 685-689.
38. Saito S, Azumi M, Muneoka Y, et al. Cost-effectiveness of combined serum anti-Helicobacter pylori IgG antibody and serum pepsinogen concentrations for screening for gastric cancer risk in Japan. Eur J Health Econ, 2018, 19(4): 545-555.
39. Yeh JM, Hur C, Ward Z, et al. Gastric adenocarcinoma screening and prevention in the era of new biomarker and endoscopic technologies: a cost-effectiveness analysis. Gut, 2016, 65(4): 563-574.
40. Zhou L, Guan P, Sun LP, et al. Health economic assessment for screening of gastric cancer in a high risk population in northeastern china. Chin J Cancer Res, 2011, 23(1): 21-24.
41. Areia M, Spaander MC, Kuipers EJ, et al. Endoscopic screening for gastric cancer: a cost-utility analysis for countries with an intermediate gastric cancer risk. United European Gastroenterol J, 2018, 6(2): 192-202.
42. Tsuji I, Fukao A, Sugawara N, et al. Cost-effectiveness analysis of screening for gastric cancer in Japan. Tohoku J Exp Med, 1991, 164(4): 279-284.
43. Babazono A, Hillman AL. Declining cost-effectiveness of screening for disease. The case of gastric cancer in Japan. Int J Technol Assess Health Care, 1995, 11(2): 354-364.
44. Tashiro A, Sano M, Kinameri K, et al. Comparing mass screening techniques for gastric cancer in Japan. World J Gastroenterol, 2006, 12(30): 4873-4874.
45. Lee HY, Park EC, Jun JK, et al. Comparing upper gastrointestinal X-ray and endoscopy for gastric cancer diagnosis in Korea. World J Gastroenterol, 2010, 16(2): 245-250.
46. Chang HS, Park EC, Chung W, et al. Comparing endoscopy and upper gastrointestinal X-ray for gastric cancer screening in South Korea: a cost-utility analysis. Asian Pac J Cancer Prev, 2012, 13(6): 2721-2728.
47. Cho E, Kang MH, Choi KS, et al. Cost-effectiveness outcomes of the national gastric cancer screening program in South Korea. Asian Pac J Cancer Prev, 2013, 14(4): 2533-2540.
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Chinese Journal of Evidence-Based Medicine

Health economics evaluation of gastric cancer prevention and screening: a systematic review

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