Opportunistic Gastric Cancer Endoscopic Screening Integrated Into Population-Based Colorectal Cancer Screening: A Retrospective Economic Cost-Comparison Study

IF 4.6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter Pub Date : 2026-10-04 DOI:10.1111/hel.70161

B. Mourato, P. Pinto, J. Vieira, M. Vidinha, V. Carvalho, N. Pratas, H. Capote, I. Fronteira, R. Dinis, M. Areia

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引用次数: 0

Abstract

Background

Gastric cancer (GC) remains a major cause of cancer-related mortality worldwide, with prognosis and treatment costs strongly influenced by disease stage at diagnosis. Endoscopic GC screening has been proposed for intermediate-to-high-risk countries, although its economic feasibility remains uncertain. This study evaluated the costs associated with opportunistic GC screening integrated into a colorectal cancer screening programme and compared modeled early-stage management scenarios with the real-world costs of managing Stages II–IV disease.

Methods

A retrospective cost-comparison study was conducted from the perspective of the Portuguese National Health Service. Screening costs were derived from 377 fecal immunochemical testing-positive individuals undergoing one-time opportunistic esophagogastroduodenoscopy (EGD) during colonoscopy within the organized colorectal cancer screening programme, and treatment costs from a retrospective cohort of 222 patients with gastric adenocarcinoma. Direct medical costs were analyzed according to disease stage and compared with two modeled early-stage management scenarios.

Results

Gastric precancerous conditions were identified in 46.9% of screened individuals, and gastric adenocarcinoma was detected in 0.8% (3/377). The estimated screening cost was €17,249 per cancer detected. Mean treatment and follow-up costs per patient were €32,140 for Stage II disease, €33,073 for Stage III disease, and €19,287 for Stage IV disease. The estimated cumulative cost of screening followed by ESD was €27,624, whereas screening followed by surgical treatment of Stage I disease was estimated at €44,493.

Conclusions

GC management is associated with substantial healthcare expenditure. The potential economic value of opportunistic GC screening is likely to depend on the detection of lesions amenable to endoscopic treatment.

Trail Registration

NCT07522320.

查看原文本刊更多论文

机会性胃癌内镜筛查整合到以人群为基础的结直肠癌筛查：一项回顾性经济成本比较研究。

背景：胃癌（GC）仍然是世界范围内癌症相关死亡的主要原因，其预后和治疗费用受到诊断时疾病分期的强烈影响。内镜下GC筛查已被提议用于中高风险国家，尽管其经济可行性仍不确定。本研究评估了将机会性GC筛查纳入结直肠癌筛查方案的相关成本，并将模拟的早期管理方案与管理II-IV期疾病的实际成本进行了比较。方法：从葡萄牙国家卫生服务的角度进行回顾性成本比较研究。筛查费用来源于377名粪便免疫化学检测呈阳性的个体，他们在结肠镜检查期间接受了一次性机会性食管胃十二指肠镜检查（EGD），这是在有组织的结直肠癌筛查计划中进行的，而治疗费用来自222名胃腺癌患者的回顾性队列。根据疾病分期分析直接医疗费用，并与两种模型早期管理方案进行比较。结果：46.9%的筛查者发现胃癌前病变，0.8%（3/377）的筛查者发现胃腺癌。每发现一种癌症的估计筛查费用为17,249欧元。II期疾病的平均治疗和随访费用为32140欧元，III期疾病为33073欧元，IV期疾病为19287欧元。筛查后进行ESD的累积成本估计为27,624欧元，而筛查后进行I期疾病手术治疗的累积成本估计为44,493欧元。结论：GC管理与大量医疗保健支出相关。机会性GC筛查的潜在经济价值可能取决于检测到的病变是否适合内镜治疗。Trail registration: NCT07522320。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.