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Table 2 Estimated lifetime effects and cost-effectiveness of gastric cancer screening strategies

From: Effect and cost-effectiveness of national gastric cancer screening in Japan: a microsimulation modeling study

Screening strategies

Lifetime screening outcomes per 1000 individuals

GC deaths predicteda

GC deaths reduction, %b

Number of endoscopiesa

QALYs gainedb,c

Total costs ($1000)c

ICER ($ per QALY gained)c,d

No screening

9.1

0.0

81

0.0

693

–

Current screening guidelines

 50–no stopping age, 3 years

2.3

74.8

14,516

30.1

2247

Dominated

 50–no stopping age, 2 years

1.8

80.5

21,379

28.1

3091

Dominated

Alterative screening strategies

 Biennial screening

  Initiation at age 50 years

   50–75, 2 years

3.0

67.3

14,873

25.9

2662

Dominated

   50–80, 2 years

2.5

72.3

16,666

27.4

2798

Dominated

  Initiation at age 45 years

   45–75, 2 years

2.7

70.3

17,237

26.4

3263

Dominated

   45–80, 2 years

2.0

77.9

19,928

28.6

3465

Dominated

  Initiation at age 40 years

   40–75, 2 years

2.5

72.7

20,559

25.5

4064

Dominated

   40–80, 2 years

2.0

77.6

22,358

26.7

4199

Dominated

 Triennial screening

  Initiation at age 50 years

   50–75, 3 years

3.4

63.0

9694

27.2

1934

45,665

   50–80, 3 years

2.8

69.1

11,507

29.4

2066

60,731

  Initiation at age 45 years

   45–75, 3 years

3.0

67.6

11,907

30.9

2380

Dominated

   45–80, 3 years

2.4

73.7

13,660

32.7

2504

130,149

  Initiation at age 40 years

   40–75, 3 years

2.8

69.6

14,101

31.1

2909

Dominated

   40–80, 3 years

2.4

73.4

15,024

31.5

2975

Dominated

  1. GC gastric cancer, QALYs quality-adjusted life-years, ICER incremental cost-effectiveness ratio. aGastric cancer deaths and number of endoscopies were not discounted. bCompared with no endoscopic screening. cDiscounted at an annual rate of 3%. dDominated strategies are those either with greater costs and fewer QALYs or with an ICER greater than its adjacent more effective strategy. Dominated strategies are excluded from ICER calculation