Endoscopy for Gastric Cancer Screening Is Cost Effective for Asian Americans in the United States.
Endoscopy for Gastric Cancer Screening Is Cost Effective for Asian Americans in the United States.
复制标题
DOI：
10.1016/j.cgh.2020.07.031
复制
发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Saumoy M
中科院分区：
文献类型：
--
作者：
Shah SC;Canakis A;Peek RM Jr;Saumoy M
在一些高发病率国家，胃癌内镜筛查已成为常规检查，并且与胃癌相关死亡率降低有关。来自胃癌高发国家和低发国家的移民仍保持高风险，但美国尚未对这些人群提出筛查建议。我们的目的是确定在中国人、菲律宾人、东南亚人、越南人、韩国人和日裔美国人中，与不进行筛查相比，不同内镜筛查策略对非贲门胃癌的成本效益。我们生成了一个决策分析马尔可夫模型来模拟一群无症状的 50 岁亚裔美国人。对每组进行内镜胃癌筛查的两种不同策略的成本效益与不进行筛查的成本效益进行比较，并按性别分层。结果指标以增量成本效益比 (ICER) 报告，支付意愿门槛为 100,000 美元/质量调整生命年 (QALY)。进行了广泛的敏感性分析。与不进行内镜胃癌筛查相比，进行1次上消化内镜活检并在发现胃肠化生时继续进行内镜监测，具有成本效益，而每两年进行一次内镜检查，即使对于内镜检查和组织病理学结果正常的患者，也没有成本效益。华裔、日裔和韩裔美国人的 ICER 最低（均低于 73,748 美元/QALY）。对于美国 50 岁或以上的亚裔美国人来说，内窥镜筛查胃癌并持续监测胃肿瘤前期是具有成本效益的。 ICER 最低的是中国人、日本人和韩裔美国人（均低于 73,748 美元/QALY）。
Endoscopic screening for gastric cancer is routine in some countries with high incidence and is associated with reduced gastric cancer-related mortality. Immigrants from countries of high incidence to low incidence of gastric cancer retain their high risk, but no screening recommendations have been made for these groups in the United States. We aimed to determine the cost effectiveness of different endoscopic screening strategies for noncardia gastric cancer, compared with no screening, among Chinese, Filipino, Southeast Asian, Vietnamese, Korean, and Japanese Americans. We generated a decision-analytic Markov model to simulate a cohort of asymptomatic 50-year-old Asian Americans. The cost effectiveness of 2 distinct strategies for endoscopic gastric cancer screening was compared with no screening for each group, stratified by sex. Outcome measures were reported in incremental cost-effectiveness ratios (ICERs), with a willingness to pay threshold of $100,000/quality-adjusted life-year (QALY). Extensive sensitivity analyses were performed. Compared with performing no endoscopic gastric cancer screening, performing a 1-time upper endoscopy with biopsies, with continued endoscopic surveillance if gastric intestinal metaplasia was identified, was cost effective, whereas performing ongoing biennial endoscopies, even for patients with normal findings from endoscopy and histopathology, was not. The lowest ICERs were observed for Chinese, Japanese, and Korean Americans (all below $73,748/QALY). Endoscopic screening for gastric cancer with ongoing surveillance of gastric preneoplasia is cost-effective for Asian Americans ages 50 years or older in the United States. The lowest ICERs are for Chinese, Japanese, and Korean Americans (all below $73,748/QALY).
登录
查看更多内容
影响因子：
3
作者：
Braithwaite, R. Scott;Meltzer, David O.;Roberts, Mark S.
通讯作者：
Roberts, Mark S.
影响因子：
3.8
作者：
Huang, Robert J.;Sharp, Nora;Palaniappan, Latha P.
通讯作者：
Palaniappan, Latha P.
影响因子：
--
作者：
Adlekha, S.;Chadha, T.;Sumangala, B.
通讯作者：
Sumangala, B.
DOI：
10.1007/s00432-016-2299-9
发表时间：
2017-03-01
影响因子：
3.6
作者：
Jiang, Jian-Xia;Liu, Qing;Xu, Shun-Fu
通讯作者：
Xu, Shun-Fu
DOI：
10.1111/j.1440-1746.2005.03898.x
发表时间：
2005-10-01
影响因子：
4.1
作者：
Ang, TL;Fock, KM;Tan, J
通讯作者：
Tan, J