Gastric Cancer Screening and Surveillance in Western Populations Show Limited Cost-Effectiveness

Strategic Insights -

A recent review of data on gastric cancer in Western populations has highlighted the limited cost-effectiveness of endoscopic screening and surveillance in detecting the disease. The study, conducted by researchers at Erasmus University Medical Center, found that while screening can reduce mortality rates, its cost-effectiveness in Western populations is unclear. The researchers evaluated 14 studies on the cost-effectiveness of endoscopic screening and surveillance, and found that routine screening may not be cost-effective for the general population. However, screening for high-risk individuals or combined with colonoscopy following a positive fecal immunochemical test improved cost-effectiveness. Endoscopic surveillance was consistently cost-effective, particularly for individuals with gastric intestinal metaplasia (GIM), showing the best cost-effectiveness at a three-to five-year interval.

Key Takeaways:

  • Gastric cancer is the fourth leading cause of cancer-related deaths worldwide, with highest incidence rates in Asia.
  • Endoscopic screening may facilitate early detection and reduce mortality, but its cost-effectiveness in Western populations remains unclear.
  • The review evaluated 14 studies on the cost-effectiveness of endoscopic screening and surveillance, including six studies on screening in the general population, three studies on screening in high-risk individuals, and seven studies on endoscopic surveillance.
  • Routine endoscopic screening may not be cost-effective in Western populations, but screening for high-risk individuals or combined with colonoscopy may improve cost-effectiveness.
  • Endoscopic surveillance is consistently cost-effective, particularly for individuals with GIM, showing the best cost-effectiveness at a three-to five-year interval.
  • The study found that higher-risk individuals with dysplasia or incomplete GIM may benefit from more frequent surveillance.

Statistics:

  • Gastric cancer is the fourth leading cause of cancer-related deaths worldwide.
  • 14 studies were evaluated in the review, including those on endoscopic screening and surveillance in Western populations.
  • Six studies were conducted on screening in the general population, three on screening in high-risk individuals, and seven on endoscopic surveillance.
  • The cost-effectiveness of endoscopic screening and surveillance ranged from 18,336 per Quality-Adjusted Life Year (QALY) in Europe to $87,000 per QALY in the USA.
  • Individuals with GIM showed the best cost-effectiveness at a three-to five-year interval, with ICERs ranging from 18,336 per QALY in Europe to $87,000 per QALY in the USA.

Sources:

  • NewsRx. Researchers at Erasmus University Medical Center Have Reported New Data on Gastric Cancer (Cost-effectiveness of Upper Endoscopy for Gastric Cancer Screening and Surveillance In Western Populations). Cancer Weekly. July 1, 2025; p 790.
  • Cost-effectiveness of Upper Endoscopy for Gastric Cancer Screening and Surveillance In Western Populations. Best Practice & Research Clinical Gastroenterology, 2025;75.