Gastric Cancer Prevention
Gastric cancer is the second leading cause of cancer-related deaths worldwide, and eleventh in the U.S. Based on current age-specific rates of gastric cancer and projected demographic changes, the annual number of expected deaths worldwide will increase from 700,000 to 1.4 million by 2030. As symptoms are often absent in the early stages of disease, gastric cancer is usually diagnosed at an advanced stage and less than 20% of patients survive five years or more. Finding effective primary and secondary prevention strategies can significantly reduce gastric cancer mortality in the U.S. and globally.
In the US, while the absolute number of cases has fallen, more than 20,000 Americans are diagnosed with gastric cancer each year, and disparities by race and ethnicity persist. Gastric cancer ranks eleventh overall for US cancer deaths, but is fifth or sixth among Asians, Blacks, and Hispanics. Hispanic men face a 50% greater risk of developing and 70% higher risk of dying from gastric cancer compared to Whites, and their prevalence of H. pylori is nearly two-fold higher. In developing countries, gastric cancer is a major public health problem, with over 40% of all cases occurring in China. Based on current age-specific rates of gastric cancer and projected demographic changes, the annual number of expected cases in China alone will increase from 393,000 in 2002 to 795,700 in 2030.
Disease simulation methods can help identify effective gastric cancer prevention programs that improve cancer outcomes, reduce disparities, and enhance the cost-effectiveness of gastric cancer prevention. This project focuses on constructing a flexible decision-analytic simulation model of gastric cancer capable of estimating the contribution of risk factor patterns on gastric cancer trends and assessing the costs, benefits, and cost-effectiveness of primary and secondary prevention strategies.