Effect of repeated endoscopic screening on the incidence and treatment of gastric cancer in health screenees

Nam, Su Youn; Choi, Il Ju; Park, Kyung Woo; Kim, Chan Gyoo; Lee, Jong Yeul; Kook, Myeong–Cherl; Lee, Jong Seok; Park, Sook Ryun; Lee, Jun Ho; Ryu, Keun Won; Kim, Young Woo

doi:10.1097/meg.0b013e328318ed42

Cited by 100 publications

(84 citation statements)

References 32 publications

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“…Korea has been providing a mass screening, recommending a biennial stomach cancer screening for those 40 years of age and older with direct upper gastrointestinal series (UGIS), endoscopy or both since 1999 [26,27]. A recent publication by the Korean Gastric Cancer Association reports that the prevalence of surgically operated early gastric cancers (EGCs) has risen gradually from 28.6 % in 1995, 32.8 % in 1999, 47.4 % in 2004 to 58.0 % in 2007 [28].…”

Section: Discussionmentioning

confidence: 99%

Age and sex interactions in gastric cancer incidence and mortality trends in Korea

et al. 2014

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Background The incidence and mortality of gastric cancer have declined rapidly over the past few decades, but reverse trends in the young generation's differential between sexes in some races have been reported in recent years. To investigate whether this divergent trend can be observed in Korea, a country with the highest incidence in the world, age-and sex-specific incidence and mortality trends were evaluated. Methods Gastric cancer incidence data for the years 1999-2010 and mortality data for the years 1983-2012 were obtained from the Korea Central Cancer Registry and National Statistical Office. Annual percentage changes were calculated by age group (20-39, 40-54, 55-69, 70-79) using Joinpoint regression analysis. Furthermore, age-period-cohort analysis was evaluated. Results Overall age-standardized gastric cancer incidence in adults aged between 20 and 79 was declining at a nonsignificant average annual percentage change (AAPC) of -0.2 % in males and -0.4 % in females in Korea during 1999-2010. Mortality was steeper at a significant rate of -4.3 and -5.9 % in males and females, respectively. However, age-specific analysis revealed a flat (males 0.2 %, 95 % CI -0.5-0.6) or increasing incidence trend (females 1.7 %, 95 % CI 0.9-2.5) in the 40-54 age group. APC analysis confirmed the decreasing incidence and mortality trend mainly by the cohort effect. Conclusions The differential pattern between males and females in different age groups suggests a possible effect of detection by screening practice or a signal of the change in epidemiological factors in the incidence and mortality of gastric cancer that warrants further studies.

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Section: Discussionmentioning

confidence: 99%

Age and sex interactions in gastric cancer incidence and mortality trends in Korea

et al. 2014

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“…Additionally, upper age limits of 75 and 80 years are also recommended for screening the male population. Indeed, the incidence and mortality risk of gastric cancer increased in older people (Ito et al, 2009;Nam et al, 2009). Meanwhile, considering the greater proportion of non-screening among males over 70 years old in 2002 and 2003 (Table 2), a more intensive screening strategy with endoscopy may be needed for the aged, especially those with a higher risk of gastric cancers .…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness Outcomes of the National Gastric Cancer Screening Program in South Korea

Cho¹,

Kang²,

Choi³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Although screening is necessary where gastric cancer is particularly common in Asia, the performance outcomes of mass screening programs have remained unclear. This study was conducted to evaluate cost-effectiveness outcomes of the national cancer screening program (NCSP) for gastric cancer in South Korea. Materials and Methods: People aged 40 years or over during 2002-2003 (baseline) were the target population. Screening recipients and patients diagnosed with gastric cancers were identified using the NCSP and Korea Central Cancer Registry databases. Clinical outcomes were measured in terms of mortality and life-years saved (LYS) of gastric cancer patients during 7 years based on merged data from the Korean National Health Insurance Corporation and National Statistical Office. We considered direct, indirect, and productivity-loss costs associated with screening attendance. Incremental cost-effectiveness ratio (ICER) estimates were produced according to screening method, sex, and age group compared to non-screening. Results: The age-adjusted ICER for survival was 260,201,000-371,011,000 Korean Won (KW; 1USD=1,088 KW) for the upper-gastrointestinal (UGI) tract over non-screening. Endoscopy ICERs were lower (119,099,000-178,700,000 KW/survival) than UGI. To increase 1 life-year, additional costs of approximately 14,466,000-15,014,000 KW and 8,817,000-9,755,000 KW were required for UGI and endoscopy, respectively. Endoscopy was the most cost-effective strategy for males and females. With regard to sensitivity analyses varying based on the upper age limit, endoscopy NCSP was dominant for both males and females. For males, an upper limit of age 75 or 80 years could be considered. ICER estimates for LYS indicate that the gastric cancer screening program in Korea is cost-effective. Conclusion: Endoscopy should be recommended as a first-line method in Korea because it is beneficial among the Korean population.

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“…Mortality according to age and gender was assessed using National Statistical Office 2008 data (Korea National Statistical Office, 2010). The stage distribution and the survival outcomes in the unscreened population were projected on the basis of local studies (Hansson et al, 1999;Kubota et al, 2000;Dan et al, 2006;Kunisaki et al, 2006;Miyamoto et al, 2007;Nam et al, 2009). The corresponding outcomes for the screened population were projected from clinical studies conducted in Korea or Japan (Kubota et al, 2000;Han et al, 2003;Nam et al, 2009).…”

Section: Incidence and Prevalence Ratesmentioning

confidence: 99%

Comparing Endoscopy and Upper Gastrointestinal X-ray for Gastric Cancer Screening in South Korea: A Cost-utility Analysis

Chang

Park

Chung

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Background: There are limited data evaluating the cost-effectiveness of gastric cancer screening using endoscopy or upper gastrointestinal x-ray in the general population. Objective: To evaluate the costeffectiveness of population-based screening for gastric cancer in South Korea by decision analysis. Methods: A time-dependent Markov model for gastric cancer was constructed for healthy adults 30 years of age and older, and a deterministic sensitivity analysis was performed. Cost-utility analysis with multiple strategies was conducted to compare the costs and effects of 13 different screening alternatives with respect to the following eligibility criteria: age at the beginning of screening, screening interval, and screening method. The main outcome measurement was the incremental cost-effectiveness ratio. Results: The results revealed that annual endoscopic screening from ages 50-80 was the most cost-effective for the male population. In the females, biennial endoscopy screening from ages 50-80 was calculated as the most cost-effective strategy among the 12 screening alternatives. The most cost-effective screening strategy may be adjustable according to the screening costs and the distribution of cancer stage at screening. The limitation was that effectiveness data were obtained from published sources. Conclusions: Using the threshold of $19,162 per quality-adjusted life year on the basis of the Korean gross domestic product (2008), as suggested by the World Health Organization, endoscopic gastric cancer screening starting at the age of 50 years was highly cost-effective in the Korean population. The national recommendation for gastric cancer screening should consider the starting age of screening, the screening interval, and the screening modality.

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Effect of repeated endoscopic screening on the incidence and treatment of gastric cancer in health screenees

Abstract: Repeated endoscopic screening within 2 years decreased the incidence of gastric cancer and endoscopic resection could be applied to more patients who underwent EGD screening within 2 years.

Cited by 100 publications

References 32 publications

Age and sex interactions in gastric cancer incidence and mortality trends in Korea

Age and sex interactions in gastric cancer incidence and mortality trends in Korea

Cost-effectiveness Outcomes of the National Gastric Cancer Screening Program in South Korea

Comparing Endoscopy and Upper Gastrointestinal X-ray for Gastric Cancer Screening in South Korea: A Cost-utility Analysis

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