{"corpus_id":27103283,"paper_sha":"9ab5160059214d4b17e2c72dda1b38e623c087f2","doi":"10.1016/S0140-6736(96)01501-2","arxiv_id":null,"pmid":8684154,"pmcid":null,"mag_id":2163581846,"dblp_id":null,"acl_id":null,"title":"Modelling cost-effectiveness of Helicobacter pylori screening to prevent gastric cancer: a mandate for clinical trials.","year":1996,"publication_date":"1996-07-20","venue":"The Lancet","journal":{"name":"Lancet","pages":"\n          150-4\n        ","volume":"348 9021"},"journal_issn":null,"journal_title":null,"publication_types":["JournalArticle","Review"],"pubmed_pub_types":["Journal Article","Research Support, Non-U.S. Gov't","Research Support, U.S. Gov't, Non-P.H.S."],"s2_fields_of_study":["Medicine","Economics"],"reference_count":24,"citation_count":336,"influential_citation_count":6,"is_open_access":false,"arxiv_categories":null,"arxiv_license":null,"arxiv_journal_ref":null,"mesh_headings":[{"d":"Adenocarcinoma","mj":false,"qs":[{"q":"prevention & control","mj":true,"ui":"Q000517"}],"ui":"D000230"},{"d":"Case-Control Studies","mj":false,"ui":"D016022"},{"d":"Clinical Trials as Topic","mj":false,"qs":[{"q":"economics","mj":false,"ui":"Q000191"}],"ui":"D002986"},{"d":"Cost-Benefit Analysis","mj":false,"ui":"D003362"},{"d":"Costs and Cost Analysis","mj":false,"ui":"D003365"},{"d":"Decision Support Techniques","mj":false,"ui":"D003661"},{"d":"Female","mj":false,"ui":"D005260"},{"d":"Helicobacter Infections","mj":false,"qs":[{"q":"drug therapy","mj":false,"ui":"Q000188"},{"q":"economics","mj":true,"ui":"Q000191"},{"q":"epidemiology","mj":false,"ui":"Q000453"},{"q":"prevention & control","mj":true,"ui":"Q000517"}],"ui":"D016481"},{"d":"Helicobacter pylori","mj":true,"ui":"D016480"},{"d":"Humans","mj":false,"ui":"D006801"},{"d":"Male","mj":false,"ui":"D008297"},{"d":"Mass Screening","mj":false,"qs":[{"q":"economics","mj":true,"ui":"Q000191"}],"ui":"D008403"},{"d":"Middle Aged","mj":false,"ui":"D008875"},{"d":"Models, Economic","mj":true,"ui":"D018803"},{"d":"Research Design","mj":false,"ui":"D012107"},{"d":"Sensitivity and Specificity","mj":false,"ui":"D012680"},{"d":"Stomach Neoplasms","mj":false,"qs":[{"q":"prevention & control","mj":true,"ui":"Q000517"}],"ui":"D013274"},{"d":"United States","mj":false,"qs":[{"q":"epidemiology","mj":false,"ui":"Q000453"}],"ui":"D014481"}],"chemicals":null,"comments_corrections":null,"source_flags":5,"s2_open_access_pdf_url":null,"s2_open_access_landing_url":null,"s2_open_access_license":null,"s2_open_access_status":null,"pmc_open_access_pdf_url":null,"pmc_open_access_landing_url":null,"pmc_open_access_license":null,"pmc_open_access_status":null,"unpaywall_open_access_pdf_url":null,"unpaywall_open_access_landing_url":null,"unpaywall_open_access_license":null,"unpaywall_open_access_status":null,"abstract":"BACKGROUND\nIt is unknown whether eradication of Helicobacter pylori infection prevents development of gastric adenocarcinoma. To determine whether screening and treatment trials are warranted, we conducted a cost-effectiveness analysis to estimate the costs and benefits associated with screening for H pylori at age 50 and treating those individuals infected with antibiotics.\n\n\nMETHODS\nWe compared two interventions: (1) screen for H pylori and treat those with a positive test, and (2) do not screen and do not treat. Estimates of risks and costs were obtained by review of published reports. Since the efficacy of H pylori therapy in cancer prevention is unknown, we did sensitivity analyses, varying this estimate widely. In our base-case analysis, we assumed that H pylori treatment prevented 30% of attributable gastric cancers.\n\n\nFINDINGS\nIn the base-case analysis, 11,646,000 persons in the US would be screened and 4,658,400 treated, at a cost of $996 million. Cost-effectiveness was $25,000 per year of life saved. Cost-effectiveness was sensitive to the efficacy of the cancer prevention strategy. At low efficacy rates (< 10%), the screening programme was more expensive (> $75,000 per year of life saved). In a high-risk group such as Japanese-Americans, however, screening and treatment required less than $50,000 per year of life saved, even at 5% treatment efficacy.\n\n\nINTERPRETATION\nScreening and treatment for H pylori infection is potentially cost-effective in the prevention of gastric cancer, particularly in high-risk populations. Cancer prevention trials are strongly recommended.","claims":[{"public_id":"cl_4a25287c3d2435bcec9eccb3c7c442b6","status":"active","text":"Cost-effectiveness declines substantially when treatment efficacy for cancer prevention is low, exceeding $75,000 per year of life saved at efficacy below 10%.","confidence":0.95,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_4a25287c3d2435bcec9eccb3c7c442b6"},{"public_id":"cl_aa7ea8d2259c9365c37e5c31ef6bc409","status":"active","text":"In a high-risk population such as Japanese-Americans, screening and treatment remain below $50,000 per year of life saved even when treatment efficacy is 5%.","confidence":0.95,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous 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