The Cost-Effectiveness of Adding Helicobacter Pylori Screening to the National Gastric Cancer Screening Program in Korea: Protocol for a Cost-Effectiveness Modeling Study
BackgroundIn Korea, the National Cancer Screening Program (NCSP) was implemented in 1999 and provides biennial endoscopy for adults aged ≥40 years. The NCSP has contributed to the early detection of gastric cancer and reduction of associated mortality in Korea. Helicobacter p...
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JMIR Publications
2025-07-01
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| author | Seowoo Bae Joon Sung Kim Moon Won Lee Gwang Ha Kim Young-Il Kim Woon Tae Jung Gwang Ho Baik Beom Jin Kim Joongyub Lee Mina Suh Jae Gyu Kim |
| author_facet | Seowoo Bae Joon Sung Kim Moon Won Lee Gwang Ha Kim Young-Il Kim Woon Tae Jung Gwang Ho Baik Beom Jin Kim Joongyub Lee Mina Suh Jae Gyu Kim |
| author_sort | Seowoo Bae |
| collection | DOAJ |
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BackgroundIn Korea, the National Cancer Screening Program (NCSP) was implemented in 1999 and provides biennial endoscopy for adults aged ≥40 years. The NCSP has contributed to the early detection of gastric cancer and reduction of associated mortality in Korea. Helicobacter pylori is the main cause of gastric cancer. Screening for and eradication of H pylori reduces the incidence and mortality of gastric cancer. Previous studies have reported that screening for H pylori is a cost-saving intervention that can significantly decrease gastric cancer burden in areas with a high prevalence of H pylori infection. However, no study has examined whether incorporating H pylori screening into national endoscopic screening is cost effective.
ObjectiveThis study aims to evaluate the cost-effectiveness of incorporating H pylori screening into Korea’s National Gastric Cancer Screening Program.
MethodsWe have developed a Markov model to compare two strategies: (1) endoscopy screening every 2 years starting at the age of 40 years (conventional screening), and (2) H pylori screening at the age of 40 years followed by continuous endoscopy screening every 2 years. We will also conduct a comparative analysis by varying the age at which the H pylori screening is performed. The primary outcome is the incremental cost-utility ratio (ICUR), calculated by dividing the incremental cost by the incremental quality-adjusted life-years (QALYs) between the two strategies. A probabilistic sensitivity analysis will be performed to test the uncertainty of the cost-effectiveness results. A sensitivity analysis will identify the most influential variables for cost-effectiveness.
ResultsThe primary outcome parameter is the cost-effectiveness of adding H pylori testing to the current NCSP, which is expressed as the ICUR. Costs and utilities are discounted at an annual rate of 4.5%. The ICUR threshold is set at KRW 50 million (US $36,719), which is the South Korean gross domestic product per capita. This research has been funded by a Patient-Centered Clinical Research Coordinating Center grant from the Ministry of Health & Welfare, Republic of Korea (grant RS-2024-00398474). This study will analyze and synthesize previously published information and is thus exempt from institutional review board approval. Data collection started in June 2024 and was completed in May 2025. Study results will be published in peer-reviewed journals and presented at national and international conferences throughout 2025.
ConclusionsWe will examine whether introducing H pylori testing and eradication therapy into the NCSP is a more cost-effective strategy for reducing gastric cancer risk than conventional endoscopy-based screening. Our study also examines the optimal age for H pylori screening, as well as the optimal screening frequency.
International Registered Report Identifier (IRRID)DERR1-10.2196/72228 |
| format | Article |
| id | doaj-art-9700bc2c42994235bddb7c9a0e2f3db2 |
| institution | OA Journals |
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| publishDate | 2025-07-01 |
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| spelling | doaj-art-9700bc2c42994235bddb7c9a0e2f3db22025-08-20T02:39:04ZengJMIR PublicationsJMIR Research Protocols1929-07482025-07-0114e7222810.2196/72228The Cost-Effectiveness of Adding Helicobacter Pylori Screening to the National Gastric Cancer Screening Program in Korea: Protocol for a Cost-Effectiveness Modeling StudySeowoo Baehttps://orcid.org/0000-0002-8123-388XJoon Sung Kimhttps://orcid.org/0000-0001-9158-1012Moon Won Leehttps://orcid.org/0000-0002-8411-6398Gwang Ha Kimhttps://orcid.org/0000-0001-9721-5734Young-Il Kimhttps://orcid.org/0000-0002-2614-3419Woon Tae Junghttps://orcid.org/0000-0002-1464-5462Gwang Ho Baikhttps://orcid.org/0000-0003-1419-7484Beom Jin Kimhttps://orcid.org/0000-0002-0938-6697Joongyub Leehttps://orcid.org/0000-0003-2784-3772Mina Suhhttps://orcid.org/0000-0001-8101-7493Jae Gyu Kimhttps://orcid.org/0000-0002-4841-9404 BackgroundIn Korea, the National Cancer Screening Program (NCSP) was implemented in 1999 and provides biennial endoscopy for adults aged ≥40 years. The NCSP has contributed to the early detection of gastric cancer and reduction of associated mortality in Korea. Helicobacter pylori is the main cause of gastric cancer. Screening for and eradication of H pylori reduces the incidence and mortality of gastric cancer. Previous studies have reported that screening for H pylori is a cost-saving intervention that can significantly decrease gastric cancer burden in areas with a high prevalence of H pylori infection. However, no study has examined whether incorporating H pylori screening into national endoscopic screening is cost effective. ObjectiveThis study aims to evaluate the cost-effectiveness of incorporating H pylori screening into Korea’s National Gastric Cancer Screening Program. MethodsWe have developed a Markov model to compare two strategies: (1) endoscopy screening every 2 years starting at the age of 40 years (conventional screening), and (2) H pylori screening at the age of 40 years followed by continuous endoscopy screening every 2 years. We will also conduct a comparative analysis by varying the age at which the H pylori screening is performed. The primary outcome is the incremental cost-utility ratio (ICUR), calculated by dividing the incremental cost by the incremental quality-adjusted life-years (QALYs) between the two strategies. A probabilistic sensitivity analysis will be performed to test the uncertainty of the cost-effectiveness results. A sensitivity analysis will identify the most influential variables for cost-effectiveness. ResultsThe primary outcome parameter is the cost-effectiveness of adding H pylori testing to the current NCSP, which is expressed as the ICUR. Costs and utilities are discounted at an annual rate of 4.5%. The ICUR threshold is set at KRW 50 million (US $36,719), which is the South Korean gross domestic product per capita. This research has been funded by a Patient-Centered Clinical Research Coordinating Center grant from the Ministry of Health & Welfare, Republic of Korea (grant RS-2024-00398474). This study will analyze and synthesize previously published information and is thus exempt from institutional review board approval. Data collection started in June 2024 and was completed in May 2025. Study results will be published in peer-reviewed journals and presented at national and international conferences throughout 2025. ConclusionsWe will examine whether introducing H pylori testing and eradication therapy into the NCSP is a more cost-effective strategy for reducing gastric cancer risk than conventional endoscopy-based screening. Our study also examines the optimal age for H pylori screening, as well as the optimal screening frequency. International Registered Report Identifier (IRRID)DERR1-10.2196/72228https://www.researchprotocols.org/2025/1/e72228 |
| spellingShingle | Seowoo Bae Joon Sung Kim Moon Won Lee Gwang Ha Kim Young-Il Kim Woon Tae Jung Gwang Ho Baik Beom Jin Kim Joongyub Lee Mina Suh Jae Gyu Kim The Cost-Effectiveness of Adding Helicobacter Pylori Screening to the National Gastric Cancer Screening Program in Korea: Protocol for a Cost-Effectiveness Modeling Study JMIR Research Protocols |
| title | The Cost-Effectiveness of Adding Helicobacter Pylori Screening to the National Gastric Cancer Screening Program in Korea: Protocol for a Cost-Effectiveness Modeling Study |
| title_full | The Cost-Effectiveness of Adding Helicobacter Pylori Screening to the National Gastric Cancer Screening Program in Korea: Protocol for a Cost-Effectiveness Modeling Study |
| title_fullStr | The Cost-Effectiveness of Adding Helicobacter Pylori Screening to the National Gastric Cancer Screening Program in Korea: Protocol for a Cost-Effectiveness Modeling Study |
| title_full_unstemmed | The Cost-Effectiveness of Adding Helicobacter Pylori Screening to the National Gastric Cancer Screening Program in Korea: Protocol for a Cost-Effectiveness Modeling Study |
| title_short | The Cost-Effectiveness of Adding Helicobacter Pylori Screening to the National Gastric Cancer Screening Program in Korea: Protocol for a Cost-Effectiveness Modeling Study |
| title_sort | cost effectiveness of adding helicobacter pylori screening to the national gastric cancer screening program in korea protocol for a cost effectiveness modeling study |
| url | https://www.researchprotocols.org/2025/1/e72228 |
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