Dataset Information

Effect and cost-effectiveness of national gastric cancer screening in Japan: a microsimulation modeling study.

ABSTRACT:

Background

A national endoscopic screening program for gastric cancer was rolled out in Japan in 2015. We used a microsimulation model to estimate the cost-effectiveness of current screening guidelines and alternative screening strategies in Japan.

Methods

We developed a microsimulation model that simulated a virtual population corresponding to the Japanese population in risk factor profile and life expectancy. We evaluated 15 endoscopic screening scenarios with various starting ages, stopping ages, and screening intervals. The primary outcomes were quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratio. Cost-effective screening strategies were determined using a willingness-to-pay threshold of $50,000 per QALY gained. One-way sensitivity and probabilistic sensitivity analyses were done to explore model uncertainty.

Results

Using the threshold of $50,000 per QALY, a triennial screening program for individuals aged 50 to 75 years was the cost-effective strategy, with an incremental cost-effectiveness ratio of $45,665. Compared with no endoscopic screening, this strategy is predicted to prevent 63% of gastric cancer mortality and confer 27.2 QALYs gained per 1000 individuals over a lifetime period. Current screening guidelines were not on the cost-effectiveness efficient frontier. The results were robust on one-way sensitivity analyses and probabilistic sensitivity analysis.

Conclusions

This modeling study suggests that the endoscopic screening program in Japan would be cost-effective when implemented between age 50 and 75 years, with the screening repeated every 3 years. These findings underscore the need for further evaluation of the current gastric cancer screening recommendations.

SUBMITTER: Huang HL

PROVIDER: S-EPMC7489209 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Publications

Effect and cost-effectiveness of national gastric cancer screening in Japan: a microsimulation modeling study.

Huang Hsi-Lan HL Leung Chi Yan CY Saito Eiko E Katanoda Kota K Hur Chin C Kong Chung Yin CY Nomura Shuhei S Shibuya Kenji K

BMC medicine 20200914 1

<h4>Background</h4>A national endoscopic screening program for gastric cancer was rolled out in Japan in 2015. We used a microsimulation model to estimate the cost-effectiveness of current screening guidelines and alternative screening strategies in Japan.<h4>Methods</h4>We developed a microsimulation model that simulated a virtual population corresponding to the Japanese population in risk factor profile and life expectancy. We evaluated 15 endoscopic screening scenarios with various starting a ...[more]

PMID: 32921305

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Dataset Information

Effect and cost-effectiveness of national gastric cancer screening in Japan: a microsimulation modeling study.

Background

Methods

Results

Conclusions

Publications

Effect and cost-effectiveness of national gastric cancer screening in Japan: a microsimulation modeling study.

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