Cost-effectiveness of combined serum anti-Helicobacter pylori IgG antibody and serum pepsinogen levels for gastric cancer-risk screening

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K08889
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Medical sociology
• Research Institution: Niigata University of Health and Welfare
• Principal Investigator: Saito Shota 新潟医療福祉大学, 医療経営管理学部, 助教 (60739465)
• Co-Investigator(Kenkyū-buntansha): 赤澤 宏平 新潟大学, 医歯学総合病院, 教授 (10175771) ; 石川 卓 新潟大学, 医歯学総合病院, 准教授 (70586940)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 費用対効果 / 胃がん / 検診 / ヘリコバクター・ピロリ菌 / マルコフモデル

Outline of Final Research Achievements

Helicobacter pylori infection and the degree of chronic atrophic gastritis are significant predictors for the development of gastric cancer, especially in the Japanese population. A combination of assays for serum anti-Helicobacter pylori immunoglobulin G antibody (HPA) and serum pepsinogen (PG) levels can be used to identify gastric cancer risk. In Japan, this ABC method may be an effective approach for identifying high-risk individuals who should undergo gastric cancer screening. The present study’s purpose was to estimate the long-term cost-effectiveness of the ABC method for assessing the gastric cancer risk in a Japanese population. We constructed a Markov cohort model to estimate the cost-effectiveness of ABC method. We suggested that a combination of HPA and serum PG assays plus scheduling endoscopy accordingly is a cost-effective strategy of screening for gastric cancer risk in Japan.

Free Research Field

医療経済学

Academic Significance and Societal Importance of the Research Achievements

あらかじめ胃がんリスクを判定し、検診の必要性の少ない対象者と高い対象者を分類することは不要な検診費用を削減できるため極めて効率的な検診の運用方法である。日本の胃がんの発症率は諸外国と比較して非常に高く、発症予防と検診による早期発見に力を注ぐべき消化器疾患の１つとされている。ヘリコバクター・ピロリ菌の除菌治療による胃がんの発症予防とリスクの高い対象者へ集中的に精度の高いサーベイランスを行う検診方法の有用性が医療経済的な観点から示された。