Tomio Nakayama, Director of the Social and Health Research Center of the National Cancer Center, collaborated with the University of Tokyo to investigate the cost-effectiveness of endoscopic examination of gastric cancer by simulation. We found that it was best to do it every three years.
Nakayama et al. Constructed a simulation model that reflected the risk and mortality rate of gastric cancer in Japanese, and evaluated the start age and end age of gastric cancer endoscopy and the consultation interval cost-effectively.Smoking rate and Helicobacter pylori infection rate are incorporated as risk factors, and the examination is performed only by endoscopy, and the lesions found are excised.
According to the report, the most cost-effective combination was a start age of 50 years, an end age of 75 or 80 years, and a consultation interval of 3 years.It was more cost-effective than the 50-year-old start, no end age, and three-year visits stipulated in the current guidelines of the National Cancer Center.
The National Cancer Center has published the 2014 guideline and recommends consultations in line with it, but it does not include a cost-effectiveness perspective.In the United States, a simulation model including cost-effectiveness is created for the target age and consultation interval, and the optimum conditions are known.In Japan as well, in order to make effective use of limited medical resources, the same efforts as in the United States were required.
Paper information:[BMC Medicine] Effect and cost-effectiveness of national gastric cancer screening in Japan: a microsimulation modeling study