Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang Province, China.
Dig Dis Sci. 2020 Jun;65(6):1679-1688. doi: 10.1007/s10620-019-05910-1. Epub 2019 Oct 30.
Helicobacter pylori (H. pylori) eradication can reduce the prevalence of gastric cancer. However, whether H. pylori eradication therapy should be performed in infected patients, especially in asymptomatic cases, is still controversial.
The aims of this study were to determine whether H. pylori screening and eradication could prevent gastric cancer in a cost-effective way, and further whether eradication therapy should be administered to asymptomatic individuals.
Cost-effectiveness analysis was performed using a Markov model. We established two groups, each with 10,000 hypothetical Chinese individuals at the age of 40 years. Clinical outcomes and cost of H. pylori eradication were compared between the eradication and control groups.
There was a lower morbidity with gastric cancer in the eradication group than in the control group, which was most significant after running the model for 15 years. The eradication group experienced an average of 34.64 quality-adjusted life years (QALYs) per person, and the average cost was US $1706.52 per person. The control group exhibited an average of 32.63 QALYs per person, and the average cost was US $2045.10 per person. The cost-effectiveness analysis showed that eradication saved $1539 per LY per person and $168.45 per QALY per person.
H. pylori screening and eradication therapy effectively reduces the morbidity of gastric cancer and cancer-related costs in asymptomatic infected individuals. Therefore, we believe that H. pylori eradication can prevent gastric cancer in a cost-effective way.
幽门螺杆菌（H. pylori）的根除可以降低胃癌的发生率。然而，对于感染者，尤其是无症状感染者，是否应进行 H. pylori 根除治疗仍存在争议。
本研究旨在确定 H. pylori 筛查和根除是否能以具有成本效益的方式预防胃癌，以及根除治疗是否应针对无症状个体进行。
采用 Markov 模型进行成本效益分析。我们建立了两组，每组包含 10000 名年龄为 40 岁的假想中国个体。比较了根除组和对照组之间根除和控制的临床结果和成本。
根除组的胃癌发病率低于对照组，在模型运行 15 年后差异最为显著。根除组每人平均获得 34.64 个质量调整生命年（QALY），人均成本为 1706.52 美元。对照组每人平均获得 32.63 个 QALY，人均成本为 2045.10 美元。成本效益分析表明，根除治疗每延长 1 个生命年每人可节省 1539 美元，每延长 1 个 QALY 每人可节省 168.45 美元。
H. pylori 的筛查和根除治疗可有效降低无症状感染者胃癌的发病率和与癌症相关的成本。因此，我们认为 H. pylori 的根除可以以具有成本效益的方式预防胃癌。
