Helicobacter Pylori Related Gastric Cancer Screening and Cost-Effectiveness Analysis: A Hospital-Based Cross-Sectional Study (SIGES).

To evaluate the effectiveness of Helicobacter pylori (Hp) related gastric cancer screening (Hp-GCS) and cost-effectiveness of protocol candidates in a hospital-based cross-sectional study. A total of 163 gastric cancer patients in West China Hospital were retrospectively collected according to ICD-1...

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Publicado en:Nutrition & Cancer Vol. 74; no. 8; pp. 2769 - 2779
Autores principales: Xiang, Wen, Wang, Rui, Bai, Dan, Yu, Tian-Hang, Chen, Xin-Zu
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd 2022
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Taylor & Francis Ltd
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        10.1080/01635581.2021.2022168
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        atl: Helicobacter Pylori Related Gastric Cancer Screening and Cost-Effectiveness Analysis: A Hospital-Based Cross-Sectional Study (SIGES).
      aug:
        au:
          Xiang, Wen
          Wang, Rui
          Bai, Dan
          Yu, Tian-Hang
          Chen, Xin-Zu
        affil: Department of Gastrointestinal Surgery & Laboratory of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China
      sug:
        subj:
          Cost Benefit Analysis
          Cancer Screening
          Helicobacter Infections Complications
          Stomach Neoplasms Diagnosis
          Human
          Cross Sectional Studies
          Hospitals
          China
          Registries, Disease
          ROC Curve
          Helicobacter Infections Epidemiology
          Breath Tests Methods
          Confidence Intervals
          Sensitivity and Specificity
          Age Factors
          Endoscopy
      ab: To evaluate the effectiveness of Helicobacter pylori (Hp) related gastric cancer screening (Hp-GCS) and cost-effectiveness of protocol candidates in a hospital-based cross-sectional study. A total of 163 gastric cancer patients in West China Hospital were retrospectively collected according to ICD-10 code and histologic proof between April 1, 2013 and March 31, 2014, and 15,599 cancer-free controls were simultaneously collected from the health checkup registry. Hp infection was examined by urea breath test (UBT). The prevalence of Hp infection was compared between patients and controls. The diagnostic performance of UBT-based predictive index was tested in both training and validation settings. Cost-effectiveness analysis was conducted to assess candidates of Hp-GCS protocols. The prevalence of Hp infection was 55.8% and 41.2% in gastric cancers and controls, respectively (p < 0.001). UBT-based model showed moderate diagnostic strength in Hp-GCS (AUC = 0.78, 95% CI 0.74–0.82), better than UBT alone (p < 0.001). The sensitivity and specificity of UBT-based index were 80.2% and 61.9% at optimal cutoff in training setting, comparable in validation setting, which sensitivity and specificity were 76.9% and 59.6%. Number needed to screen was decreased along with older age, as well as stronger positivity of UBT. The optimal cost-effective Hp-GCS protocol with detection rate (DR = 77.9%) was endoscopic screening in age 40–59 years and positive UBT, or age ≥60 years without UBT. Incremental analysis suggested a preferable protocol as endoscopic screening in age ≥40 years without UBT (DR = 93.3%). UBT had moderate diagnostic strength in massive gastric cancer screening, and might be cost-effective in middle-aged population (40–59 years). More robust Hp-GCS protocol needs further investigate in test methods and individual biologic features.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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