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Cost-effectiveness of combined serum anti-Helicobacter pylori IgG antibody and serum pepsinogen concentrations for screening for gastric cancer risk in Japan

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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.

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Authors and Affiliations

  1. Department of Medical Informatics and Statistics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Shota Saito, Motoi Azumi, Yusuke Muneoka & Katsuhiko Nishino

  2. Department of Health Informatics, Niigata University of Health and Welfare, Niigata, Japan

    Shota Saito

  3. Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Motoi Azumi & Shuji Terai

  4. Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Yusuke Muneoka & Takashi Ishikawa

  5. Department of Medical Informatics, Niigata University Medical and Dental Hospital, 1-754 Asahimachi, Chuo-ku, Niigata, 951-8520, Japan

    Shota Saito, Takashi Ishikawa & Kouhei Akazawa

  6. Division of Endoscopy, Niigata University Medical and Dental Hospital, Niigata, Japan

    Yuichi Sato

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  1. Shota Saito
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Correspondence to Shota Saito.

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The authors declare that they have no conflicts of interest.

Funding

This work was supported by a Grant-in-Aid for Research Activity Start-up and Challenging Research from the Niigata University of Health and Welfare, 2015 grant no. H27A01, and the Japan Society for the Promotion of Science KAKENHI grant no. 16K08889.

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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 19, 545–555 (2018). https://doi.org/10.1007/s10198-017-0901-y

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  • DOI: https://doi.org/10.1007/s10198-017-0901-y

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