Endoscopic screening for gastric cancer: A cost-utility analysis for countries with an intermediate gastric cancer risk
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 Mark...
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| Veröffentlicht in: | United European gastroenterology journal 2018-03, Vol.6 (2), p.192-202 |
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| creator | Areia, Miguel Spaander, Manon CW Kuipers, Ernst J Dinis-Ribeiro, Mário |
| description | 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 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. |
| doi_str_mv | 10.1177/2050640617722902 |
| format | Article |
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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.</description><identifier>ISSN: 2050-6406</identifier><identifier>EISSN: 2050-6414</identifier><identifier>DOI: 10.1177/2050640617722902</identifier><identifier>PMID: 29511549</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>costs and cost analysis ; early detection of cancer ; gastrointestinal endoscopy ; Markov chains ; Original ; Stomach neoplasm</subject><ispartof>United European gastroenterology journal, 2018-03, Vol.6 (2), p.192-202</ispartof><rights>Author(s) 2017</rights><rights>2018 The Authors. UEG Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology</rights><rights>Author(s) 2017 2017 United European Gastroenterology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4847-2678bc3d4aed82eeacc5b12a686853bf52859a482578e1ebc15b924cfd1d28f3</citedby><cites>FETCH-LOGICAL-c4847-2678bc3d4aed82eeacc5b12a686853bf52859a482578e1ebc15b924cfd1d28f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5833230/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5833230/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,729,782,786,887,1419,11569,27931,27932,45581,45582,46059,46483,53798,53800</link.rule.ids><linktorsrc>$$Uhttps://onlinelibrary.wiley.com/doi/abs/10.1177%2F2050640617722902$$EView_record_in_Wiley-Blackwell$$FView_record_in_$$GWiley-Blackwell</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29511549$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Areia, Miguel</creatorcontrib><creatorcontrib>Spaander, Manon CW</creatorcontrib><creatorcontrib>Kuipers, Ernst J</creatorcontrib><creatorcontrib>Dinis-Ribeiro, Mário</creatorcontrib><title>Endoscopic screening for gastric cancer: A cost-utility analysis for countries with an intermediate gastric cancer risk</title><title>United European gastroenterology journal</title><addtitle>United European Gastroenterol J</addtitle><description>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.</description><subject>costs and cost analysis</subject><subject>early detection of cancer</subject><subject>gastrointestinal endoscopy</subject><subject>Markov chains</subject><subject>Original</subject><subject>Stomach neoplasm</subject><issn>2050-6406</issn><issn>2050-6414</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNqFkcFLHDEUxkNpqWK991Ry7GVqkkkymR4KVlZbELzoOWQyb9bY2WSbN-Oy_32jq0srFHNJeO_3ffngI-QjZ184b5oTwRTTkunyFqJl4g05fBhVWnL5dv9m-oAcI96xcoyRQsj35EC0inMl20OyWcQ-oU_r4Cn6DBBDXNIhZbp0OOUy9S56yF_pKfUJp2qewhimLXXRjVsM-Mj6NMcCA9JNmG7LjoY4QV5BH9wEL6xoDvjrA3k3uBHh-Ok-Itfni-uzH9Xl1cXPs9PLyksjm0roxnS-7qWD3ggA573quHDaaKPqblDCqNZJI1RjgEPnuepaIf3Q816YoT4i33a267kraTyUmG606xxWLm9tcsH-u4nh1i7TvVWmrkXNisHnJ4Ocfs-Ak10F9DCOLkKa0QrGueZaSVlQtkN9TogZhv03nNmHxuzLxork09_x9oLnfgrQ7oBNGGH7qqG9WVyI7-elad4UbbXToluCvUtzLpXh_8P8AVjEsMA</recordid><startdate>201803</startdate><enddate>201803</enddate><creator>Areia, Miguel</creator><creator>Spaander, Manon CW</creator><creator>Kuipers, Ernst J</creator><creator>Dinis-Ribeiro, Mário</creator><general>SAGE Publications</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201803</creationdate><title>Endoscopic screening for gastric cancer: A cost-utility analysis for countries with an intermediate gastric cancer risk</title><author>Areia, Miguel ; Spaander, Manon CW ; Kuipers, Ernst J ; Dinis-Ribeiro, Mário</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4847-2678bc3d4aed82eeacc5b12a686853bf52859a482578e1ebc15b924cfd1d28f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>costs and cost analysis</topic><topic>early detection of cancer</topic><topic>gastrointestinal endoscopy</topic><topic>Markov chains</topic><topic>Original</topic><topic>Stomach neoplasm</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Areia, Miguel</creatorcontrib><creatorcontrib>Spaander, Manon CW</creatorcontrib><creatorcontrib>Kuipers, Ernst J</creatorcontrib><creatorcontrib>Dinis-Ribeiro, Mário</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>United European gastroenterology journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Areia, Miguel</au><au>Spaander, Manon CW</au><au>Kuipers, Ernst J</au><au>Dinis-Ribeiro, Mário</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endoscopic screening for gastric cancer: A cost-utility analysis for countries with an intermediate gastric cancer risk</atitle><jtitle>United European gastroenterology journal</jtitle><addtitle>United European Gastroenterol J</addtitle><date>2018-03</date><risdate>2018</risdate><volume>6</volume><issue>2</issue><spage>192</spage><epage>202</epage><pages>192-202</pages><issn>2050-6406</issn><eissn>2050-6414</eissn><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.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>29511549</pmid><doi>10.1177/2050640617722902</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library (Open Access Collection) |
| subjects | costs and cost analysis early detection of cancer gastrointestinal endoscopy Markov chains Original Stomach neoplasm |
| title | Endoscopic screening for gastric cancer: A cost-utility analysis for countries with an intermediate gastric cancer risk |
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