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Cost-effectiveness of screening with polymerase chain reaction for Helicobacter pylori to prevent gastric cancer and peptic ulcers.
| Content Provider | Europe PMC |
|---|---|
| Author | Oh, Aaron Truong, Han Kim, Judith Rustgi, Sheila D. Abrams, Julian A. Hur, Chin |
| Copyright Year | 2022 |
| Abstract | BackgroundHelicobacter pylori (H. pylori) is a major risk factor for gastric cancer. Screening and treatment of H. pylori may reduce the risk of gastric cancer and peptic ulcer disease (PUD). Polymerase chain reaction (PCR) of gastric biopsies provides superior sensitivity and specificity for the detection of H. pylori. This study explores whether population-based H. pylori screening with PCR is cost-effective in the US.MethodsA Markov cohort state-transition model was developed to compare three strategies: no screening with opportunistic eradication, 13C-UBT population screening and treating of H. pylori, and PCR population screening and treating of H. pylori. Estimates of risks and costs were obtained from published literature. Since the efficacy of H. pylori therapy in gastric cancer prevention is not certain, we broadly varied the benefit 30–100% in sensitivity analysis.ResultsPCR screening was cost-effective and had an incremental-cost effectiveness ratio per quality adjusted life-year (QALY) of $38,591.89 when compared to 13C-UBT strategy with an ICER of $2,373.43 per QALY. When compared to no screening, PCR population screening reduced cumulative gastric cancer incidence from 0.84% to 0.74% and reduced PUD risk from 14.8% to 6.0%. The cost-effectiveness of PCR screening was robust to most parameters in the model.ConclusionsOur modeling study finds PCR screening and treating of H. pylori to be cost-effective in the prevention of gastric cancer and PUD. However, the potential negative consequences of H. pylori eradication such as antibiotic resistance could change the balance of benefits of population screening. |
| Related Links | https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9660075&blobtype=pdf |
| ISSN | 20786891 |
| Journal | Journal of Gastrointestinal Oncology [J Gastrointest Oncol] |
| Volume Number | 13 |
| DOI | 10.21037/jgo-21-911 |
| PubMed Central reference number | PMC9660075 |
| Issue Number | 5 |
| PubMed reference number | 36388653 |
| e-ISSN | 2219679X |
| Language | English |
| Publisher | AME Publishing Company |
| Publisher Date | 2022-10-01 |
| Access Restriction | Open |
| Rights License | Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0. 2022 Journal of Gastrointestinal Oncology. All rights reserved. |
| Subject Keyword | Helicobacter pylori (H. pylori) gastric cancer peptic ulcer disease (PUD) polymerase chain reaction (PCR) |
| Content Type | Text |
| Resource Type | Article |
| Subject | Gastroenterology Oncology |
