{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T05:28:33Z","timestamp":1755926913903,"version":"3.41.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Patients with head and neck neoplasms (HNN) are at an increased risk of esophageal neoplasia (EN) and gastric neoplasia (GN). We aimed to assess the clinical impact and cost-utility of endoscopic screening in this population in the Western setting.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In this single-center study HNN patients eligible for curative treatment underwent screening esophagogastroduodenoscopy. We assessed the frequency, clinical, and pathological outcomes of EN and GN. The cost-effectiveness of an annual endoscopic screening for EN was evaluated from a societal perspective, using a Markov model and probabilistic sensitivity analysis. In addition, we performed a sensitivity analysis using data on the prevalence of detected EN lesions in the four largest previous Western studies on this topic.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Forty-six HNN patients met the inclusion criteria and underwent endoscopic screening. Six EN were detected in five patients (10.9%, 95% confidence interval: 1.9\u201319.9%). Additionally, five GN were detected in five patients. Most patients had early-stage EN or GN (90%) and were treated with endoscopic resection (80%). Endoscopic screening strategy had an incremental cost-effectiveness ratio of 39\u2005357.8 \u20ac\/quality-adjusted life years gained, being cost-effective at a willingness-to-pay threshold of two times the Portuguese gross domestic product per capita. In the sensitivity analysis, it remained cost-effective when considering the prevalence of EN reported in Germany, France, and Brazil.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>An endoscopic screening program identified EN or GN in a fifth of HNN patients, most presenting at an early stage. The program implementation appears to be cost-effective in Portugal. These results may be applicable to other medium-to-high-income Western countries.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/meg.0000000000002988","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T19:00:31Z","timestamp":1747162831000},"page":"815-825","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Cost-utility and clinical impact of endoscopic screening for esophageal and gastric neoplasia in patients with head and neck neoplasms"],"prefix":"10.1097","volume":"37","author":[{"given":"Rui","family":"Morais","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o"},{"name":"Faculty of Medicine"}]},{"given":"Jo\u00e3o","family":"Afonso","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o"},{"name":"Faculty of 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Lu\u00edsa","family":"Sacramento","sequence":"additional","affiliation":[{"name":"Faculty of Medicine"},{"name":"Department of Pathology"}]},{"given":"Mariana","family":"Simpl\u00edcio","sequence":"additional","affiliation":[{"name":"Faculty of Medicine"},{"name":"Department of Pathology"}]},{"given":"Isabel","family":"Faria-Ramos","sequence":"additional","affiliation":[{"name":"Department of Pathology"}]},{"given":"Lu\u00eds","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Autonomous Management Unit"}]},{"given":"Margarida","family":"Marques","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o"},{"name":"Faculty of Medicine"}]},{"given":"Helena","family":"Silveira","sequence":"additional","affiliation":[{"name":"Faculty of Medicine"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o"}]},{"given":"Irene","family":"Gullo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine"},{"name":"Department of Pathology"},{"name":"IPATIMUP\/i3S, University of Porto, Porto, Portugal"}]},{"given":"F\u00e1tima","family":"Carneiro","sequence":"additional","affiliation":[{"name":"Faculty of Medicine"},{"name":"Department of Pathology"},{"name":"IPATIMUP\/i3S, University of Porto, Porto, Portugal"}]},{"given":"Jo\u00e3o","family":"Santos-Antunes","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o"},{"name":"Faculty of Medicine"},{"name":"IPATIMUP\/i3S, University of Porto, Porto, Portugal"}]},{"given":"Guilherme","family":"Macedo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o"},{"name":"Faculty of 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