Cost-effectiveness of Barrett's oesophagus screening and surveillance

Louisa Gordon, George Mayne

    Research output: Contribution to journalArticle

    9 Citations (Scopus)

    Abstract

    Endoscopic screening and surveillance of patients with Barrett's oesophagus to detect oesophageal cancer at earlier stages is contentious. As a consequence, their cost-effectiveness is also debatable. Current health economic evidence shows mixed results for demonstrating their value, mainly due to varied assumptions around progression rates to cancer, quality of life and treatment pathways. No randomized controlled trial exists to definitively support the efficacy of surveillance programs and one is unlikely to be undertaken. Contemporary treatment, cost and epidemiological data to contribute to cost-effectiveness analyses are needed. Risk assessment to stratify patients at low- or high-risk of developing cancer should improve cost-effectiveness outcomes as higher gains will be seen for those at higher risk, and medical resource use will be avoided in those at lower risk. Rapidly changing technologies for imaging, biomarker testing and less-invasive endoscopic treatments also promise to lower health system costs and avoid adverse events in patients.

    Original languageEnglish
    Pages (from-to)893-903
    Number of pages11
    JournalBest Practice and Research in Clinical Gastroenterology
    Volume27
    Issue number6
    DOIs
    Publication statusPublished - 2013

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