H. pylori to gastric cancer: incidence-based DALY model
Interactive outcome tree · Western and East Asian populations · 30-year horizon
How to use: each population tab lets you explore three intervention levers — pre-IM eradication, post-IM eradication, and cancer screening. Pin scenarios to compare them side by side. The Population Comparison tab lets you contrast Western and East Asian baselines and match pinned scenarios from each population head-to-head. Cohort fixed at 100,000 individuals with H. pylori infection.
Key terms
DALY
Disability-Adjusted Life Year — a summary measure of overall disease burden, where one DALY represents one year of healthy life lost. Calculated as DALY = YLD + YLL.
YLD
Years Lived with Disability — years of life spent in less-than-full health, weighted by how disabling the health state is.
YLL
Years of Life Lost — years of life lost to premature death, measured against a standard life expectancy (86.5 years here).
Pre-IM / Post-IM
Timing of H. pylori eradication relative to intestinal metaplasia (IM). Pre-IM eradication is given before precancerous changes become irreversible and is much more effective at preventing cancer (46% risk reduction). Post-IM eradication still helps (20%) but cannot undo established precancerous changes — this is why timing matters.
Intervention levers
Pre-IM eradication
0%
Post-IM eradication
0%
Screening coverage
0%
Total DALYs (30yr)
—
—
Baseline (no interventions)
Cancer cases
—
—
Cancer deaths
—
—
Cohort flow through the cascade
How the starting cohort of 100,000 redistributes across disease states over 30 years
Numbers show how many people ever enter each state, as % of the starting cohort. PUD branches from chronic gastritis, competing with progression to atrophic gastritis. MALT lymphoma branches from infection directly.
Pinned scenarios
Intervention levers
Pre-IM eradication
0%
Post-IM eradication
0%
Screening coverage
0%
Total DALYs (30yr)
—
—
Baseline (no interventions)
Cancer cases
—
—
Cancer deaths
—
—
Cohort flow through the cascade
How the starting cohort of 100,000 redistributes across disease states over 30 years
Higher upstream progression in East Asia (CG → AG 4% annually vs 1.5% Western) drives substantially more flow into downstream states. Screening is the dominant lever for shifting stage-at-detection toward early-stage cancer.
Pinned scenarios
Baseline comparison: natural history
Western and East Asian populations with no interventions (pre-IM eradication, post-IM eradication, and screening all at 0%)
Headline outcomes
What drives the difference
Parameter
Western
East Asian
Ratio (EA÷W)
Same pathway, different intensity. East Asian populations face substantially higher gastric cancer burden driven by faster upstream progression (CG → AG at 4%/year vs 1.5%), leading to more cohort members reaching the precancerous and cancerous stages. The DALY gap is partially offset by better detection (screening shifts stage-at-detection) and higher stage-specific survival, but the underlying cascade intensity dominates.
Compare pinned scenarios
Pick one scenario from each population to compare them head to head. Scenarios are pinned on the Western and East Asian tabs.
References
Every numbered reference cited across the model's methodology tables. Numbering matches the phase 1 research document; references are grouped by category here for easier navigation.