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

Shota Saito (), Motoi Azumi, Yusuke Muneoka, Katsuhiko Nishino, Takashi Ishikawa, Yuichi Sato, Shuji Terai and Kouhei Akazawa
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Shota Saito: Niigata University Graduate School of Medical and Dental Sciences
Motoi Azumi: Niigata University Graduate School of Medical and Dental Sciences
Yusuke Muneoka: Niigata University Graduate School of Medical and Dental Sciences
Katsuhiko Nishino: Niigata University Graduate School of Medical and Dental Sciences
Takashi Ishikawa: Niigata University Graduate School of Medical and Dental Sciences
Yuichi Sato: Niigata University Medical and Dental Hospital
Shuji Terai: Niigata University Graduate School of Medical and Dental Sciences
Kouhei Akazawa: Niigata University Medical and Dental Hospital

The European Journal of Health Economics, 2018, vol. 19, issue 4, No 6, 545-555

Abstract: 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.

Keywords: Cost-effectiveness; Gastric cancer; Helicobacter pylori; Markov model; Screening (search for similar items in EconPapers)
JEL-codes: I18 (search for similar items in EconPapers)
Date: 2018
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Citations: View citations in EconPapers (1)

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DOI: 10.1007/s10198-017-0901-y

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