ArticleGut2016
Gastric adenocarcinoma screening and prevention in the era of new biomarker and endoscopic technologies: a cost-effectiveness analysis.
Article in Gut, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 4 syntheses or guidelines pooled it, 101 citations in OpenAlex.
- Economic Evaluation of Gastric Cancer Screening Strategies: A Systematic Review.Journal of gastrointestinal cancer · 2025Pooled it
- Guideline
- Simulation Models in Gastric Cancer Screening: A Systematic ReviewAsian Pacific journal of cancer prevention : APJCP · 2018Pooled it
- Pooled it
- Biomarkers in Gastric Cancer: Blood Biomarkers, Liquid Biopsy, Artificial Intelligence, and Risk-Stratified Care.Cancers · 2026Review
- The Cost-Effectiveness of Gastric Cancer Screening and Surveillance Among Average-Risk and Risk-Stratified Populations.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Article
- Revisiting gastric cancer disparities in Asian American subgroups: insights from the SEER database.Frontiers in oncology · 2026Article
- Factors Associated with Malignant Gastric Ulcers: A 10-year Retrospective Cohort Study.International journal of general medicine · 2026Article
- Cost-Effectiveness of Serum Pepsinogen as a Gastric Cancer Targeted Screening Strategy in the United States.Gastro hep advances · 2025Article
- Review
- Review
- Role of the Microbiome in the Diagnosis and Management of Gastroesophageal Cancers.Journal of gastrointestinal cancer · 2024Review
- Racial disparities of gastric cancer in the USA: an overview of epidemiology, global screening guidelines, and targeted screening in a heterogeneous population.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2024Review
- Evolving Concepts in Helicobacter pylori Management.Gastroenterology · 2024Review
- Risk Prediction Models for Gastric Cancer: A Scoping Review.Journal of multidisciplinary healthcare · 2024Article
- Applying machine learning techniques to predict the risk of distant metastasis from gastric cancer: a real world retrospective study.Frontiers in oncology · 2024Article
- The prediction model of operative link on gastric intestinal metaplasia stage III-IV: A multicenter study.Heliyon · 2023Article
- Global burden of gastric cancer: epidemiological trends, risk factors, screening and prevention.Nature reviews. Clinical oncology · 2023Review
- A Global Perspective on Gastric Cancer Screening: Which Concepts Are Feasible, and When?Cancers · 2023Review
- Cost-Effectiveness Analysis of Hp and New Gastric Cancer Screening Scoring System for Screening and Prevention of Gastric Cancer.Current oncology (Toronto, Ont.) · 2023Article
Corrections and comments
- Commented on byGut to lung.2016
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo estimate the cost-effectiveness of noncardia gastric adenocarcinoma (NCGA) screening strategies based on new biomarker and endoscopic technologies.
designUsing an intestinal-type NCGA microsimulation model, we evaluated the following one-time screening strategies for US men: (1) serum pepsinogen to detect gastric atrophy (with endoscopic follow-up of positive screen results), (2) endoscopic screening to detect dysplasia and asymptomatic cancer (with endoscopic mucosal resection (EMR) treatment for detected lesions) and (3) Helicobacter pylori screening and treatment. Screening performance, treatment effectiveness, cancer and cost data were based on published literature and databases. Subgroups included current, former and never smokers. Outcomes included lifetime cancer risk and incremental cost-effectiveness ratios (ICERs), expressed as cost per quality-adjusted-life-year (QALY) gained.
resultsScreening the general population at age 50 years reduced the lifetime intestinal-type NCGA risk (0.24%) by 26.4% with serum pepsinogen screening, 21.2% with endoscopy and EMR and 0.2% with H. pylori screening/treatment. Targeting current smokers reduced the lifetime risk (0.35%) by 30.8%, 25.5%, and 0.1%, respectively. For all subgroups, serum pepsinogen screening was more effective and more cost-effective than all other strategies, although its ICER varied from $76,000/QALY (current smokers) to $105,400/QALY (general population). Results were sensitive to H. pylori prevalence, screen age and serum pepsinogen test sensitivity. Probabilistic sensitivity analysis found that at a $100,000/QALY willingness-to-pay threshold, the probability that serum pepsinogen screening was preferred was 0.97 for current smokers.
conclusionsAlthough not warranted for the general population, targeting high-risk smokers for serum pepsinogen screening may be a cost-effective strategy to reduce intestinal-type NCGA mortality.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.