Clinical and economic effects of population-based Helicobacter pylori screening to prevent Gastric cancer.
Helicobacter pylori infection has been identified as a risk factor for certain types of gastric cancer.
However, the extent to which H pylori eradication decreases the risk of gastric cancer is unknown, raising the question of whether population-based H pylori screening should be undertaken.
To compare clinical and economic effects of H pylori screening, with and without confirmatory testing. with no screening to prevent gastric cancer.
Decision analysis incorporating a Markov simulation.
Simulated cohorts of men and women with varying risk of gastric cancer.
Three strategies were evaluated :
(1) no screening ;
(2) H pylori serologic testing, treat those positive for H pylori, no follow-up testing ;
and (3) H pylori serologic testing, treat those positive for H pylori, followed by a test to confirm H pylori eradication, retreat those who test positive.
In the principal analysis, the risk of gastric cancer after H pylori eradication was assumed to be similar to that for those without H pylor infection.
Scenarios with less optimistic assumptions regarding risk reduction of cancer were evaluated.
Main Outcome Measures
Gastric cancer rates, discounted cost per life-year saved. (...)
Mots-clés Pascal : Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Dépistage, Prévention, Carcinome, Estomac, Stratégie, Sérologie, Etude comparative, Biologie clinique, Analyse avantage coût, Eradication, Homme, Evaluation, Etats Unis, Amérique du Nord, Amérique, Bactériose, Infection, Appareil digestif pathologie, Estomac pathologie, Tumeur maligne, Biochimie, Economie santé
Mots-clés Pascal anglais : Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Medical screening, Prevention, Carcinoma, Stomach, Strategy, Serology, Comparative study, Clinical biology, Cost benefit analysis, Eradication, Human, Evaluation, United States, North America, America, Bacteriosis, Infection, Digestive diseases, Gastric disease, Malignant tumor, Biochemistry, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0108621
Code Inist : 002B05B02F. Création : 16/11/1999.