具有低Helicobacter pylori流行率的队列中,针对胃癌进行具有成本效益的内镜查
Fumiaki Ishibashi1,2, Sho Suzuki1, Konomi Kobayashi2
1Department of Gastroenterology, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan.
Journal of gastroenterology and hepatology
|August 10, 2024
概括
最具成本效益的胃癌查包括每4年进行一次内镜检查,从40岁开始. 这一策略优化了低Helicobacter pylori流行率的个体的检测和治疗.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
背景情况:
- 胃癌 (GC) 查通过内镜在东亚很常见,但最佳策略仍在争论中.
- 这项研究的重点是低Helicobacter pylori流行率的人群的成本效益.
研究的目的:
- 确定用于胃癌检测和治疗的最具成本效益的内镜查策略.
- 根据不同的开始年龄和查间隔来评估策略.
主要方法:
- 从94,137名接受查内镜检查的参与者中提取回顾性数据.
- 构建一个马尔科夫状态过渡模型来模拟15种选策略.
- 分析净货币收益 (NMB) 和增量成本效益比率 (ICER).
主要成果:
- 从40岁开始的4年间隔策略产生了最高的NMB (97,901,578日元).
- 敏感性分析证实了从40岁开始的4年间隔对于成本效益的优越性.
- 队列主要是先前没有感染过的H. pylori (74.4%) 和肠道代塑性阴性 (94.2%).
结论:
- 每4年进行一次内镜查,从40岁开始,是最具成本效益的方法.
- 这一策略推用于胃癌查在低H. pylori流行程度的环境中.
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