Endoscopic noncardia gastric cancer screening for high-risk and ethnicities may be cost effective in the US, a recent study found. Researchers compared the cost-effectiveness of a no-screening strategy for noncardia gastric cancer compared with that of 2 endoscopic screening modalities, initiated at the time of screening colonoscopy for colorectal cancer: upper endoscopy (EGD) with biopsies and continued surveillance only if intestinal metaplasia (IM) or more sever pathology is identified, or EGD with biopsies continued every 2 years even in the absence of identified pathology. They found:

• Compared to biennial and no screening, screening EGD with continued surveillance only if indicated was cost effective for non-Hispanic blacks, Hispanics, and Asians, but not for non-Hispanic whites.
• The model was sensitive to IM prevalence, the transition rates from IM to dysplasia to local and regional cancer, the cost of endoscopy, and the cost of resection.