A mathematical simulation model to determine the optimal endoscopic screening strategy for detection of H. pylori-naïve gastric neoplasms.

Autor: Ishibashi F; Department of Gastroenterology, International University of Health and Welfare Ichikawa Hospital, 6-1-14, Konodai, Ichikawa-shi, Chiba, 272-0827, Japan. ishibashi-gast@iuhw.ac.jp., Okusa K; Faculty of Science and Engineering, Department of Data Science for Business Innovation, Chuo University, Tokyo, 112-8551, Japan., Tokai Y; Department of Gastroenterology, Cancer Institute Hospital, Tokyo, 135-8550, Japan., Hirasawa T; Department of Gastroenterology, Cancer Institute Hospital, Tokyo, 135-8550, Japan., Kawakami T; Koganei Tsurukame Clinic, Endoscopy Center, Tokyo, 184-0004, Japan., Mochida K; Department of Gastroenterology, International University of Health and Welfare Ichikawa Hospital, 6-1-14, Konodai, Ichikawa-shi, Chiba, 272-0827, Japan.; Koganei Tsurukame Clinic, Endoscopy Center, Tokyo, 184-0004, Japan., Yanai Y; National Center for Global Health and Medicine, Department of Gastroenterology, Tokyo, 162-8655, Japan., Yokoi C; National Center for Global Health and Medicine, Department of Gastroenterology, Tokyo, 162-8655, Japan., Hayashi Y; National Center for Global Health and Medicine, Department of Medical Examination Center, Tokyo, 162-8655, Japan., Ozawa SI; Department of Gastroenterology and Hepatology, Japan Community Health Care Organization Yamanashi Hospital, Yamanashi, 400-0025, Japan., Uraushihara K; Department of Gastroenterology, Showa General Hospital, Tokyo, 187-8510, Japan., Minato Y; Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, Tokyo, 141-8625, Japan., Nakanishi H; Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, 180-8610, Japan., Ueyama H; Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 113-8431, Japan., Kataoka M; Department of Gastroenterology, International University of Health and Welfare Mita Hospital, Tokyo, 108-8239, Japan., Toyama Y; Department of Gastroenterology, New Tokyo Hospital, Chiba, 270-2232, Japan., Mizokami Y; Department of Medical Examination Center, New Tokyo Hospital, Chiba, 270-2232, Japan., Suzuki S; Department of Gastroenterology, International University of Health and Welfare Ichikawa Hospital, 6-1-14, Konodai, Ichikawa-shi, Chiba, 272-0827, Japan.
Jazyk: angličtina
Zdroj: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association [Gastric Cancer] 2024 Sep; Vol. 27 (5), pp. 1078-1087. Date of Electronic Publication: 2024 Jun 27.
DOI: 10.1007/s10120-024-01525-2
Abstrakt: Background: The effectiveness of esophagogastroduodenoscopy (EGD) screening in cohorts with low Helicobacter pylori prevalence is unknown. This study aimed to develop an optimally efficient EGD screening strategy for detecting H. pylori-naïve gastric neoplasms (HpNGNs).
Methods: EGD data of 12 institutions from 2016 to 2022 were retrospectively analyzed. Age-related HpNGN prevalence, tumor growth rate, missing rate, and detection threshold size were calculated from the databases. Subsequently, using clinical data, a novel mathematical model that simultaneously simulated demographic changes and HpNGN detection was developed. Screening strategies using different starting ages (40/45/50 years) and intervals (2/5/10 years) were also compared. The detection rates of all tumors occurring within the virtual cohort and number-needed-to-test (NNT) were measured as outcomes.
Results: Data of 519,368 EGDs and 97 HpNGNs (34 pure signet ring cell carcinomas, 26 gastric adenocarcinomas of the fundic gland type, 30 foveolar gastric adenoma-Raspberry type, and seven undifferentiated-type cancer cases) were analyzed. A virtual cohort with a 70-year time horizon was used to simulate the occurrence, growth, and detection of 346,5836 people. Among the strategies with detection rate > 50%, the screening strategy with a 5-year interval starting at 45 years of age had the lowest NNT. Adopting this strategy, most HpNGNs were detected at < 20 mm in size, and the deep submucosal invasion rate was less than 30%.
Conclusions: A mathematical simulation model revealed that screening every 5 years starting at 45 years of age could efficiently assist in identifying HpNGNs at an early stage.
(© 2024. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association.)
Databáze: MEDLINE
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