Screening for Gastric Cancer and Surveillance of Premalignant Lesions: a Systematic Review of Cost‐Effectiveness Studies

Abstract

The available evidence shows that Helicobacter pylori serology or endoscopic population screening is cost-effective, while endoscopic surveillance of premalignant gastric lesions presents conflicting results. Better implementation of published guidelines and accomplishment of systematic detailed reviews are needed.

Randomized Controlled Trial for Helicobacter pylori Eradication in a Naive Portuguese Population: Is Sequential Treatment Superior to Triple Therapy in Real World Clinical Setting?

“…Eradication success was assessed by a laboratorial technician blinded to the treatment allocation, through 13 C-Urea Breath Test ( 13 C-UBT), performed 4 -6 weeks after treatment termination, and PPI suspension was mandatory for the two weeks previous to the test.…”

“…11 In fact, it has been demonstrated that HP eradication not only improves most non-malignant associated diseases, but may also reduce the future risk of gastric cancer by up to 80%, 12 and a recent meta-analysis suggests that population screening and eradication of HP strategy is cost-effective. 13 According to the Maastricht IV Consensus on HP management, 1 clarithromycin resistance in each region should determine the most adequate first-line treatment for HP eradication -in regions where the clarithromycin resistance is inferior to 15% -20%, the triple therapy (TT), containing a proton-pump inhibitor (PPI), amoxicillin and clarithromycin, is adequate, whereas if the resistance to clarithromycin is superior to this threshold, other treatment options, such as the sequential treatment (ST) (PPI plus amoxicillin followed by PPI, clarithromycin and an imidazole) could be preferable.…”

Gastric cancer prevention from the point of helicobacter

“…Areia M, et al (19) have recently made a systematic review of the cost-effectiveness of GC prevention strategies by using 2395 abstracts and 23 articles in the literature. The evidence showed that population-based serological screening and treatment of H. pylori-positive cases are cost-effective.…”

Vorstufen des Magenkarzinoms

“…Daher sollte der histopathologische Nachweis einer intraepithelialen Neoplasie im Magen stets zunächst an die Möglichkeit einer gastritisassoziierten Dysplasie denken lassen, da diese weitaus häufiger ist als ein Adenom. Die moderne endoskopische Bildgebung erleichtert zunehmend die Detektion der häufig nicht polypösen, d. h flachen dysplastischen Krebsvorstufen [2,3]. …”