| Autor: |
Ishibashi, Fumiaki, Okusa, Kosuke, Tokai, Yoshitaka, Hirasawa, Toshiaki, Kawakami, Tomohiro, Mochida, Kentaro, Yanai, Yuka, Yokoi, Chizu, Hayashi, Yuko, Ozawa, Shun-ichiro, Uraushihara, Koji, Minato, Yohei, Nakanishi, Hiroyuki, Ueyama, Hiroya, Kataoka, Mikinori, Toyama, Yuzo, Mizokami, Yuji, Suzuki, Sho |
| Předmět: |
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| Zdroj: |
Gastric Cancer; Sep2024, Vol. 27 Issue 5, p1078-1087, 10p |
| 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. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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