| Objective:Gastric cancer is one of the most common gastrointestinal tumors.Early diagnosis of gastric cancer can significantly improve the 5-year survival rate.Decision analysis Markov model was used to evaluate the cost-effectiveness of Hp and new gastric cancer screening scoring system in high incidence areas of gastric cancer.Methods:According to the cost-effectiveness theory and method,the decision analysis Markov model of applying Hp and new gastric cancer screening scoring system to screen and prevent gastric cancer at the age of 40 in areas with high incidence of gastric cancer is constructed,and three kinds of decisions are established: no screening,Hp screening and new gastric cancer screening scoring system screening.The model was constructed and operated by treeage Pro software,and the population in 40 years old areas with high incidence of gastric cancer in China was taken as the research object;The cost is considered from the social perspective;The effect is expressed by quality adjusted life years(QALYs).The uncertainty of each parameter in the model is clarified through one-dimensional sensitivity analysis and probability sensitivity analysis.Result:The results of cost-effectiveness analysis show that compared with the non screening,the cost of applying Hp screening increases by 591.09 yuan and 1.10192 QALY,for each additional QALY require additional investment 536.42 yuan,which is far less than China’s per capita GDP(80976 yuan)in 2021,and has high cost-effectiveness value;Compared with the non screening,the new gastric cancer screening scoring system has a higher QALY value(20.00893 vs 19.98036 QALY)but costs less(50710.36 vs91636.78 yuan).Therefore,the application of the new gastric cancer screening scoring system has the most cost-effective value.The results of one-way sensitivity analysis show that the probability of IM to dysplasia after intervention with a new gastric cancer screening scoring system has the most significant impact on ICER,with the increase of the probability of IM to dysplasia,the cost of obtaining one ICER is reduced.The probability sensitivity analysis concluded that the application of Hp and the new gastric cancer screening scoring system had cost-effectiveness and was stable.The cost-effectiveness acceptability curve suggests that the implementation of the new gastric cancer screening scoring system in China has economic value,good practicability and can be popularized.Conclusion:(1)In the 40 years old with high incidence of gastric cancer in China,the application of the new gastric cancer screening scoring system to screen and prevent gastric cancer needs screening cost,but it can significantly improve the detection rate of early gastric cancer,save gastric cancer related costs,obtain clinical results,and has cost-effectiveness value.(2)With the improvement of people’s material living standards and the high cost-effectiveness value of using the new gastric cancer screening scoring system to screen and prevent gastric cancer,the application of the new gastric cancer screening scoring system to screen gastric cancer in high-risk areas in China has good practicability and can be popularized.(3)The model constructed by applying Hp and the new gastric cancer screening scoring system to screen and prevent gastric cancer has good reliability for the economic evaluation of screening gastric cancer in high-risk areas in China. |
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