Helicobacter pylori Test-and-Treat Program Can Be Cost-effective to Prevent Gastric Cancer in Taiwanese Adults: Referred to the Nationwide Reimbursement Database

Hsiu Chi Cheng, Jung Der Wang, Wei Ying Chen, Chian Wei Chen, Shun Chiao Chang, Bor Shyang Sheu

研究成果: Article同行評審

17 引文 斯高帕斯(Scopus)

摘要

Background: Helicobacter pylori infection increases the risk of gastric cancer. The study aimed to compare cost-effectiveness ratios of H. pylori test-and-treat programs to prevent gastric cancer in Taiwan, referring to the nationwide reimbursement database and expected years of life lost. Materials and Methods: During 1998-2009, there were 12,857 females and 24,945 males with gastric adenocarcinoma in Taiwan National Cancer Registry. They were followed up to 2010 and linked to the reimbursement database of National Health Insurance and the national mortality registry to determine lifetime health expenditures and expected years of life lost. Cost-effectiveness ratios of H. pylori test-and-treat programs for prevention of gastric adenocarcinoma were compared between screenings with 13C-urea breath test and with anti-H. pylori IgG. Results: The test-and-treat program with anti-H. pylori IgG to prevent gastric adenocarcinoma had lower incremental cost-effectiveness ratios than that with 13C-urea breath test in both sexes (females: 244 vs 1071 US dollars/life-year; males: 312 vs 1431 US dollars/life-year). Cost saving would be achieved in an endemic area where H. pylori prevalence was >73.5%, or by selecting subpopulations with high absolute risk reduction rates of cancer after eradication. Moreover, expected years of life lost of gastric adenocarcinoma were higher and the incremental cost-effectiveness ratios of test-and-treat programs were more cost-effective in young adults (30-69 y/o) than in elders (≥70 y/o). Conclusions: The test-and-treat program with anti-H. pylori IgG shall be cost-effective to prevent gastric adenocarcinoma in a high endemic area, especially beginning at 30 years of age when H. pylori prevalence rates become stabilized.

原文English
頁(從 - 到)114-124
頁數11
期刊Helicobacter
20
發行號2
DOIs
出版狀態Published - 2015 4月 1

All Science Journal Classification (ASJC) codes

  • 消化內科
  • 傳染性疾病

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