Table 3.
Estimated number of intestinal-type NCGA deaths, screening-related deaths and net number of deaths averted associated with NCGA screening strategies for the overall cohort and smoking subgroups
| Strategy | Intestinal-type NCGA deaths*(range†) | Screening-related deaths*(range†) |
Net number of deaths averted|| (range†) |
|||||
|---|---|---|---|---|---|---|---|---|
| Total‡ | Number prevented |
Percent prevented |
Number of screens needed to prevent 1 death§ |
Number of endoscopies to prevent 1 death |
Endoscopic procedures |
Surgical procedures |
||
| Overall cohort (base case) – per 10 million men | ||||||||
| No screening | 19,014 (16,576–26,255) | -- | -- | -- | -- | -- | -- | -- |
| H. pylori screening | 18,986 (16,485–26,253) | 28 (0–220) | 0.1% (0.0–1.2%) | 331,859 (42,235–9,292,208) | N/A | 0 | 0 | 28 (0–220) |
| Serum pepsinogen screening | 13,888 (11,881–21,240) | 5,126 (4,687–8,316) | 27.0% (23.2–34.7%) | 1,813 (1,117–1,982) | 295 (216–378) | 21 (18–41) | 12 (7–29) | 5,093 (4,647–8,250) |
| Endoscopic screening | 14,867 (11,183–19,804) | 4,147 (3,822–7,324) | 21.8% (17.6–30.5%) | 2,241 (1,269–2,431) | ¶ | 108 (102–113) | 15 (6–28) | 4,024 (3,709–7,184) |
| Never smokers** | ||||||||
| No screening | 7,371 (4,261–12,039) | -- | -- | -- | -- | -- | -- | -- |
| H. pylori screening | 7,362 (4,239–7,362) | 9 (0–128) | 0.1% (0.0–1.6%) | 559,871 (39,365–5,038,922) | N/A | 0 | 0 | 9 (0–128) |
| Serum pepsinogen screening | 5,437 (2,797–9,210) | 1,934 (1,247–3,617) | 26.2% (21.8–34.9%) | 2,605 (1,393–4,041) | 367 (268–566) | 4 (4–19) | 7 (2–14) | 1,923 (1,236–3,586) |
| Endoscopic screening | 5,856 (2,983–9,871) | 1,515 (1,010–3,074) | 20.6% (15.7–30.6%) | 3,326 (1,639–4,989) | ¶ | 48 (47–52) | 6 (2–14) | 1461 (957–3,008) |
| Current smokers** | ||||||||
| No screening | 5,758 (4,836–7,344) | -- | -- | -- | -- | -- | -- | -- |
| H. pylori screening | 5,751 (4,802–7,342) | 7 (0–48) | 0.1% (0.0–0.9%) | 299,143 (43,624–2,094,067) | N/A | 0 | 0 | 7 (0–48) |
| Serum pepsinogen screening | 3,948 (3,175–4,917) | 1,810 (1,602–2,476) | 31.4% (27.8–38.5%) | 1,157 (846–1,307) | 218 (174–297) | 7 (5–12) | 3 (1–9) | 1,800 (1,593–2,458) |
| Endoscopic screening | 4,263 (3,477–5,361) | 1,495 (1,282–2,262) | 26.0% (22.3–35.2%) | 1,401 (926–1,633) | ¶ | 29 (27–32) | 6 (2–11) | 1,460 (1,253–2,224) |
| Former smokers** | ||||||||
| No screening | 5,205 (4,301–8,906) | -- | -- | -- | -- | -- | -- | -- |
| H. pylori screening | 5,193 (4,257–8,906) | 12 (0–61) | 0.2% (0.0–1.1%) | 179,965 (35,403–2,159,559) | N/A | 0 | 0 | 12 (0–61) |
| Serum pepsinogen screening | 3,823 (3,070–5,851) | 1,382 (1,231–3,055) | 26.6% (23.7–36.7%) | 1,563 (707–1,754) | 295 (160–372) | 10 (5–13) | 2 (2–12) | 1,370 (1,216–3,035) |
| Endoscopic screening | 4,068 (3,276–6,261) | 1,137 (1,025–2,690) | 21.8% (18.3–32.8%) | 1,899 (803–2,107) | ¶ | 31 (27–33) | 3 (1–8) | 1,103 (991–2,654) |
Compared to no screening strategy.
Range among 50 good-fitting natural history parameter sets.
Subgroup estimates do not sum to overall estimates because 680 intestinal-type NCGA deaths (range, 517 to 1022) among the cohort of 10 million 20-year old men occurred before screening at age 50.
For H. pylori screening strategy, range excludes parameter sets that estimated zero deaths prevented with screening. Specifically, 1 parameter set for the overall cohort, 4 for never smokers, 3 for current smokers and 9 for former smokers.
Defined as number of intestinal-type NCGA deaths prevented minus number of screening-related deaths.
Same as the number of screens needed to prevent 1 intestinal-type NCGA death because screening strategy was endoscopy-based.
Based on smoking status among individuals alive at time of screening at age 50. Results shown are per approximately 5.04 million never smokers, 2.10 million current smokers and 2.16 million former smokers. Among the cohort of 10 million 20-year men, an estimated 0.70 million died from background mortality causes before age 50 and were not included in the subgroup analyses.