PDF(Pubmed)
Abstract：
Gastric cancer (GC) poses notable economic and health burdens in settings where the incidence of disease is prevalent. Some countries have established early screening and treatment programs to address these challenges. The objectives of this systematic review were to summarize the cost-effectiveness of gastric cancer screening presented in the literature and to identify the critical factors that influence the cost-effectiveness of screening. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Economic evaluation studies of gastric cancer screening were reviewed from SCOPUS and PubMed. The Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) was used to assess the quality of reporting presented in the selected articles. Only primary economic evaluation studies addressing the cost-effectiveness, cost-utility, and cost-benefit of gastric cancer screening were selected. Two reviewers scrutinized the selected articles (title, abstract, and full text) to determine suitability for the systematic review based on inclusion and exclusion criteria. Authors\' consensus was relied on where disagreements arose. The main outcome measures of concern in the systematic review were cost, effectiveness (as measured by either quality-adjusted life years (QALY) or life-years saved (LYS)), and incremental cost-effectiveness ratio (ICER) of screening versus either no screening or an alternative screening method. Thirty-one studies were selected for the final review. These studies investigated the cost-effectiveness of GC screening based on either primary, secondary, or a combination of primary and secondary interventions. The main primary intervention was Helicobacter pylori (Hp) screening with eradication, while the main secondary intervention was endoscopic screening. Cost-effectiveness was evaluated against no screening or screening using an alternative method in both observational and model-based studies. Screening was mainly cost-effective in Asian countries or their diasporas where the prevalence of GC was high. GC screening was generally not cost-effective among Western countries. GC screening can be cost-effective, but cost-effectiveness is dependent on context-specific factors, including geographical location, the prevalence of GC in the local population, and the screening tool adopted. However, there is benefit in targeting high-risk population groups in Asian countries and their diaspora for GC screening.
摘要：
胃癌（GC）在疾病发病率普遍的环境中造成了显着的经济和健康负担。一些国家已经建立了早期筛查和治疗计划来应对这些挑战。本系统综述的目的是总结文献中提出的胃癌筛查的成本效益，并确定影响筛查成本效益的关键因素。本系统评价遵循系统评价和荟萃分析（PRISMA）指南的首选报告项目。SCOPUS和PubMed对胃癌筛查的经济学评价研究进行了综述。2022年综合卫生经济评估报告标准（CHEERS2022）用于评估选定文章中报告的质量。只有针对成本效益的主要经济评价研究，成本效用，选择胃癌筛查的成本效益。两名审稿人仔细检查了选定的文章(标题，abstract,和全文)，以根据纳入和排除标准确定系统审查的适宜性。作者的共识依赖于分歧的地方。系统审查中关注的主要结果指标是成本，有效性(以质量调整寿命年(QALY)或保存寿命年(LYS)衡量)，以及筛查与不筛查或替代筛查方法的增量成本效益比（ICER）。选择了31项研究进行最终审查。这些研究调查了基于两种主要方法的GC筛查的成本效益，次要,或主要和次要干预措施的组合。主要干预措施是根除幽门螺杆菌(Hp)筛查,而主要的次要干预是内镜筛查。在观察性研究和基于模型的研究中，对没有筛查或使用替代方法进行筛查的成本效益进行了评估。在GC患病率高的亚洲国家或其侨民中，筛查主要具有成本效益。在西方国家中，GC筛查通常没有成本效益。GC筛选可以具有成本效益，但是成本效益取决于特定环境的因素，包括地理位置,GC在当地人群中的患病率，以及采用的筛选工具。然而,针对亚洲国家及其侨民的高危人群进行GC筛查是有益的.
