Benefit-to-harm ratio and cost-effectiveness of government-recommended gastric cancer screening in China: A modeling study

Validity of self-reported participation in cancer screenings and health checkups in Japan

BACKGROUND

The participation rate for screening is regarded as a useful indicator for preventing cancer and cardio-metabolic disease. However, the validity of self-reported screening participation has not yet been thoroughly evaluated in Japan. We aimed to examine its validity using the municipal screening records among the Japanese population.

METHODS

We included 3,060 men and 3,860 women insured by the National Health Insurance for residents aged <75 years or the Medical Care System for the Elderly aged ≥75 years in the Chikusei area of the Japan Public Health Center-based Prospective Study for the Next Generation. They were asked about their participation in cancer screenings and health checkups during the previous year. We compared their responses to the municipal records and calculated the sensitivity and specificity of self-reported screening participation.

RESULTS

The sensitivity and specificity of self-reported participation were 0.49 and 0.86 for lung cancer screening; 0.67 and 0.85 for colorectal cancer screening; 0.77 and 0.79 for stomach cancer screening; and 0.86 and 0.65 for health checkup, respectively. Among women, the sensitivity and specificity were 0.83 and 0.81 for breast cancer and 0.85 and 0.90 for cervical cancer, respectively.

CONCLUSION

Self-reported cancer screening participation for colorectal, stomach, breast, and cervical cancers had moderate-high sensitivity and specificity. Self-reported participation, especially for lung cancer screening and health checkups, should be carefully interpreted when assessing the performance of preventive measures.

Knowledge and awareness of early gastrointestinal cancer screening in Sunan Yugur Autonomous County in Gansu, China

OBJECTIVE

We aimed to assess the level of knowledge and awareness regarding the need for screening of early gastrointestinal cancer among residents of Sunan Yugur Autonomous County in China.

METHODS

In this cross-sectional study, we conducted a survey among permanent residents of Sunan Yugur Autonomous County from January 2020 to January 2023 using a questionnaire to obtain data on knowledge regarding early gastrointestinal cancer screening.

RESULTS

The survey included 12,000 residents. Among participants, 62.30% (7476/12,000) were aware of the need for early gastrointestinal cancer screening. Awareness about the need for early gastrointestinal cancer screening differed significantly based on participants' sex, age, level of education, area of residence, and ethnicity.

CONCLUSION

The level of awareness regarding the need for early gastrointestinal cancer screening was relatively low in our study population. The government and medical institutions should provide information and promote early gastrointestinal cancer screening in the region to improve the health status and quality of life among the Yugur people.

Health economic evaluation on population-based Helicobacter pylori eradication and endoscopic screening for gastric cancer prevention

Gastric cancer is a global public health burden, nearly one million new cases are diagnosed per year worldwide, of which 44% of cases occur in China. The prognosis of gastric cancer varies remarkably by the stage of cancer, and most of the patients in China are diagnosed at advanced stages, resulting in poor prognoses. Effective strategies to reduce the burden of gastric cancer include primary prevention through testing and treatment of Helicobacter pylori (H. pylori) and secondary prevention by screening and early detection. Although many countries have issued management guidelines and consensus reports concerning these strategies, the limited availability of healthcare resources often precludes their widespread implementation. Therefore, assessing the costs, benefits, and harms of population-based intervention measures through health economic evaluation is necessary for informed health policy decisions. Accordingly, we synthesize management approaches from different countries on H. pylori eradication and endoscopic screening, and also summarize recent advancements in health economic evaluations on population-based preventive strategies. The goal of the review is to provide empirical evidence supporting optimal resource allocation, maximizing benefits for the population, and ultimately reducing the burden of gastric cancer.