{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T11:53:08Z","timestamp":1779105188604,"version":"3.51.4"},"reference-count":45,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestion"],"abstract":"<jats:p>Background: In Japan, biennial esophagogastroduodenoscopy (EGD) screening for gastric cancer (GC) has been implemented for adults aged \u226550 years as part of a population-based screening program. This approach has facilitated early GC detection and demonstrated individual-level benefits. However, due to a generational decline in Helicobacter pylori infection, a reduction in the long-term effectiveness of this strategy is anticipated. Given the allocation of national resources, a cost-effectiveness evaluation is essential. Summary: As GC prevalence declines in the target population, the cost-effectiveness of existing screening practices may diminish. Mathematical simulation models are commonly employed to assess the comparative effectiveness and cost-effectiveness of various cancer screening strategies. Microsimulation models, which track individual-level outcomes, are utilized to evaluate person-level effects. By contrast, macrosimulation models \u2013 such as Markov and decision tree models \u2013 are used to assess population-level outcomes. Key Messages: Nine studies have compared different EGD screening strategies. These studies support the effectiveness of biennial screening in high-risk countries. In low- to intermediate-risk countries \u2013 and among lower risk populations within high-risk countries \u2013 extending the screening interval to \u22653 years appears reasonable. Additionally, strategies incorporating risk stratification using alternative modalities, such as serological tests, are more cost-effective. Continued discussion is necessary to optimize the EGD screening approach.<\/jats:p>","DOI":"10.1159\/000546835","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T12:02:05Z","timestamp":1749124925000},"page":"616-623","source":"Crossref","is-referenced-by-count":5,"title":["Cost-Effective Endoscopic Screening Strategies for Asymptomatic Gastric Cancer"],"prefix":"10.1159","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4065-7958","authenticated-orcid":false,"given":"Fumiaki","family":"Ishibashi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kosuke","family":"Okusa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0079088"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/cas.12829"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1111\/den.14063"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2014.608"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.3892\/mco.2023.2649"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-058774"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-017-0688-7"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12184"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16132353"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2015.03.013"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2766-2"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocaa022"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2024.11.001"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.12.022"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2022.37.e24"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-34215-7"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.5230\/jgc.2024.24.e41"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2021.482"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.11.286"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1111\/cas.13100"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2013.07.021"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1186\/s13058-022-01505-3"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X10369005"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/584739"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-024-01525-2"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-81092-z"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.abd6370"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1098\/rsta.2023.0132"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114461"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-021-01713-5"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2017.11.010"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-020-01729-0"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.2188\/jea.5.67"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2006.03.025"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.7314\/apjcp.2012.13.6.2721"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0083959"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.21403"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-021-01162-z"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.16715"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2022.167"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1055\/a-1594-1833"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-308588"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-022-07795-z"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.01.029"}],"container-title":["Digestion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000546835","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000546835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T17:03:09Z","timestamp":1764954189000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000546835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,5]]},"references-count":45,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,12,5]]},"published-print":{"date-parts":[[2025,12,10]]}},"URL":"https:\/\/doi.org\/10.1159\/000546835","archive":["Portico"],"relation":{},"ISSN":["0012-2823","1421-9867"],"issn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