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@ARTICLE{Krilaviciute:132823,
      author       = {A. Krilaviciute$^*$ and C. Stock$^*$ and M. Leja and H.
                      Brenner$^*$},
      title        = {{P}otential of non-invasive breath tests for preselecting
                      individuals for invasive gastric cancer screening
                      endoscopy.},
      journal      = {Journal of breath research},
      volume       = {12},
      number       = {3},
      issn         = {1752-7163},
      address      = {Bristol},
      publisher    = {IOP},
      reportid     = {DKFZ-2018-00467},
      pages        = {036009 -},
      year         = {2018},
      abstract     = {Regular screening for gastric cancer (GC) is based on
                      invasive upper gastrointestinal endoscopy and is limited to
                      few high-incidence countries. As GC is a major cause of
                      cancer death worldwide, a non-invasive, simple screening
                      test is of value. We assessed the prevalence of preclinical
                      GC and the corresponding numbers needed to screen (NNS) to
                      detect GC cases both without and with preselection using
                      breath tests from the literature in various
                      populations.Using age- and sex-specific GC incidence data
                      and rates of transition from preclinical to clinical GC, we
                      estimated the prevalences of preclinical GC worldwide in
                      populations aged 50-74 years, and we evaluated the accuracy
                      of breath testing for GC detection based on published
                      studies. We then derived the expected positive predictive
                      values for breath testing in populations with different
                      preclinical GC prevalences.Four studies reporting the
                      sensitivity and specificity of breath tests were identified,
                      and summary estimates of $83\%$ sensitivity and $91\%$
                      specificity were derived by meta-analysis. The estimates of
                      the overall prevalence of preclinical GC were $<0.5\%$ in
                      men and $<0.2\%$ in women aged 50-74 years across different
                      regions of the world. The positive predictive values, the
                      prevalence among breath test positive people, were
                      approximately nine-fold higher in all populations, resulting
                      in an approximately nine-fold lower NNS to detect one GC
                      case when breath tests were used for preselection for
                      screening.Given the low prevalence of preclinical GC,
                      non-invasive breath tests show promise for making screening
                      more efficient. Further validation of breath tests and
                      evidence on the rates of transition from preclinical to
                      clinical GC are needed to validate the breath test
                      approach.},
      cin          = {C070 / G110 / L101},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)G110-20160331 /
                      I:(DE-He78)L101-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29528036},
      doi          = {10.1088/1752-7163/aab5be},
      url          = {https://inrepo02.dkfz.de/record/132823},
}