Gastric cancer is a global public health burden, nearly one million new cases are diagnosed per year worldwide, of which 44% of cases occur in China. The prognosis of gastric cancer varies remarkably by the stage of c...Gastric cancer is a global public health burden, nearly one million new cases are diagnosed per year worldwide, of which 44% of cases occur in China. The prognosis of gastric cancer varies remarkably by the stage of cancer, and most of the patients in China are diagnosed at advanced stages, resulting in poor prognoses. Effective strategies to reduce the burden of gastric cancer include primary prevention through testing and treatment of Helicobacter pylori(H. pylori) and secondary prevention by screening and early detection. Although many countries have issued management guidelines and consensus reports concerning these strategies, the limited availability of healthcare resources often precludes their widespread implementation. Therefore, assessing the costs, benefits, and harms of population-based intervention measures through health economic evaluation is necessary for informed health policy decisions. Accordingly, we synthesize management approaches from different countries on H. pylori eradication and endoscopic screening, and also summarize recent advancements in health economic evaluations on population-based preventive strategies. The goal of the review is to provide empirical evidence supporting optimal resource allocation, maximizing benefits for the population, and ultimately reducing the burden of gastric cancer.展开更多
Objective To evaluate the economy of detecting gastric cancer by electronic gastroscope in Chinese natural population of different ages and genders.Methods A Markov model was constructed for the population,including b...Objective To evaluate the economy of detecting gastric cancer by electronic gastroscope in Chinese natural population of different ages and genders.Methods A Markov model was constructed for the population,including both men and women of different ages.The model cycle was one year and the simulation time was 60 years.The cost-effectiveness of electronic gastroscopy in detecting gastric cancer of general population in China was analyzed from the perspective of the whole society,and the stability of the results was verified by sensitivity analysis.Results and Conclusion For the general population,the incremental cost-effectiveness ratio(ICER)of gastric cancer screening from the age of 50 is 50143 yuan/QALY(quality-adjusted life-year),which is less than two times of per capita gross domestic product(GDP)compared with the screening from the age of 55.For men who start gastric cancer screening at the age of 50,the ICER is 38525 yuan/QALY,which is less than two times of per capita GDP,and it is economical.For women who start the screening from the age of 55,the ICER is 47814 yuan/QALY,which is less than two times of per capita GDP,so it is economical.The results of sensitivity analysis are consistent with the conclusions of basic analysis,and the results of basic analysis are stable.For the general population,it is more economical to start gastric cancer screening from the age of 50,while for men and women,it is more economical to start gastric cancer screening from the age of 50 and 55,respectively.展开更多
基金supported in part by the Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support (No. ZLRK202325)a grant from National Key R&D Program of China (No. 2018YFC 1313105)。
文摘Gastric cancer is a global public health burden, nearly one million new cases are diagnosed per year worldwide, of which 44% of cases occur in China. The prognosis of gastric cancer varies remarkably by the stage of cancer, and most of the patients in China are diagnosed at advanced stages, resulting in poor prognoses. Effective strategies to reduce the burden of gastric cancer include primary prevention through testing and treatment of Helicobacter pylori(H. pylori) and secondary prevention by screening and early detection. Although many countries have issued management guidelines and consensus reports concerning these strategies, the limited availability of healthcare resources often precludes their widespread implementation. Therefore, assessing the costs, benefits, and harms of population-based intervention measures through health economic evaluation is necessary for informed health policy decisions. Accordingly, we synthesize management approaches from different countries on H. pylori eradication and endoscopic screening, and also summarize recent advancements in health economic evaluations on population-based preventive strategies. The goal of the review is to provide empirical evidence supporting optimal resource allocation, maximizing benefits for the population, and ultimately reducing the burden of gastric cancer.
文摘Objective To evaluate the economy of detecting gastric cancer by electronic gastroscope in Chinese natural population of different ages and genders.Methods A Markov model was constructed for the population,including both men and women of different ages.The model cycle was one year and the simulation time was 60 years.The cost-effectiveness of electronic gastroscopy in detecting gastric cancer of general population in China was analyzed from the perspective of the whole society,and the stability of the results was verified by sensitivity analysis.Results and Conclusion For the general population,the incremental cost-effectiveness ratio(ICER)of gastric cancer screening from the age of 50 is 50143 yuan/QALY(quality-adjusted life-year),which is less than two times of per capita gross domestic product(GDP)compared with the screening from the age of 55.For men who start gastric cancer screening at the age of 50,the ICER is 38525 yuan/QALY,which is less than two times of per capita GDP,and it is economical.For women who start the screening from the age of 55,the ICER is 47814 yuan/QALY,which is less than two times of per capita GDP,so it is economical.The results of sensitivity analysis are consistent with the conclusions of basic analysis,and the results of basic analysis are stable.For the general population,it is more economical to start gastric cancer screening from the age of 50,while for men and women,it is more economical to start gastric cancer screening from the age of 50 and 55,respectively.