This paper presents an empirically calibrated mathematical model of gastric cancer and H. pylori in China and Colombia to provide qualitative insight into the cost-effectiveness of gastric cancer prevention strategies. Despite studies that have established the relationship between Helicobacter pylori and gastric cancer and H. pylori treatment reducing cancer incidence among individuals without preexisting precancerous lesions, screening for H. pylori is still being debated.
The authors synthesized available data to develop a natural history model of noncardia intestinal gastric adenocarcinomas with health states such as normal gastric mucosa, chronic nonatrophic gastritis, gastric atrophy, intestinal metaplasia, dysplasia, and gastric cancer that were all stratified by H. pylori status. A likelihood-based empirical calibration approach was used to identify good-fitting parameter sets consistent with epidemiologic data. A range of likely outcomes associated with H. pylori screening that incorporated parameter uncertainty were reflected in the results.
Yeh JM, Kuntz KM, Ezzati M et al. Development of an Empirically Calibrated Model of Gastric Cancer in Two High-Risk Countries. Cancer Epidemiology Biomarkers & Prevention 2008; 17 (5): 1179-1187. http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=18483340