Thématique :
- Cancers autres (hors CCR et CHC)
Originalité :
Très original
Solidité :
Très solide
Doit faire évoluer notre pratique :
Dans certains cas
Nom du veilleur :
Professeur Sylvain MANFREDI
Coup de coeur :
Digestive and Liver Disease
  2017 Mar;49(3):291-296  
  doi: 10.1016/j.dld.2016.12.004  
  Cost of detecting gastric neoplasia by surveillance endoscopy in atrophic gastritis in Italy: A low risk country  
  Lahner E, Hassan C, Esposito G, Carabotti M, Zullo A, Dinis-Ribeiro M, Annibale B  



Atrophic gastritis (AG) is at increased risk of gastric neoplasia, thus surveillance gastroscopy has been proposed.


To assess cost of detecting gastric neoplasias by surveillance endoscopy according to identified risk factors in Italy.


Post-hoc analysis of a cohort study including 200 AG-patients from Italy followed up for a mean of 7.5 (4-23.4) years was done. Considered risk factors were: age >50years, extensive atrophy, pernicious anaemia, OLGA-OLGIM scores 3-4 at diagnosis. The number of 4-year-surveillance endoscopies needed to be performed to detect one gastric neoplasia (NNS) was calculated.


In 19 patients neoplasias (4 gastric cancers, 8 type 1 gastric carcinoids, 7 dysplasias) were detected at the 361 surveillance gastroscopies, corresponding to NNS of 19 and a cost per gastric neoplastic lesion of €2945. By restricting surveillance to pernicious anaemia patients, reduction of NNS and cost per neoplasia to 13.8 and €2139 may be obtained still detecting 74% of neoplasias. By limiting the surveillance to pernicious anaemia patients and OLGA 3-4, 5 (26.3%) neoplasias would have been detected with a corresponding NNS of 5.4 and a cost per lesion of €837.


Risk factors may allow an efficient allocation of financial and medical resources for endoscopic surveillance in AG in a low risk country.

Question posée
La surveillance endoscopique des gastrites atrophiques est-elle coût-efficace ?
Question posée
La surveillance endoscopique tous les 4 ans des gastrites atrophiques est coût-efficace surtout chez les sujets avec anémie ferriprive.