Cost-Effectiveness of Liver Cancer Screening in Adults at High Risk for Liver Cancer in the Republic of Korea.
- Author:
Young Hwa LEE
1
;
Kui Son CHOI
;
Jae Kwan JUN
;
Mina SUH
;
Hoo Yeon LEE
;
Youn Nam KIM
;
Chung Mo NAM
;
Eun Cheol PARK
;
Woo Hyun CHO
Author Information
1. National Cancer Control Institute, National Cancer Center, Goyang, Korea. kschoi@ncc.re.kr
- Publication Type:Original Article
- Keywords:
Liver neoplasms;
Screening;
Cost-benefit analysis
- MeSH:
Adult*;
alpha-Fetoproteins;
Cost-Benefit Analysis;
Female;
Humans;
Korea;
Liver Neoplasms*;
Male;
Mass Screening*;
Republic of Korea*;
Ultrasonography
- From:Cancer Research and Treatment
2014;46(3):223-233
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study was conducted in order to determine the most cost-effective strategy, in terms of interval and age range, for liver cancer screening in the high-risk population of Korea. MATERIALS AND METHODS: A stochastic model was used to simulate the cost-effectiveness of liver cancer screening by combined ultrasonography and alpha-fetoprotein testing when varying both screening intervals and age ranges. The effectiveness of these screening strategies in the high-risk population was defined as the probability of detecting preclinical liver cancer, and cost was based on the direct cost of the screening and confirmative tests. Optimal cost-effectiveness was determined using the incremental cost-effectiveness ratio. RESULTS: Among the 36 alternative strategies, one-year or two-year interval screening for men aged between 50 and 80 years, six-month or one-year interval screening for men aged between 40 and 80 years, and six-month interval screening for men aged between 30 and 80 years were identified as non-dominated strategies. For women, identified non-dominated strategies were: one-year interval screening between age 50 and 65 years, one-year or six-month interval screening between age 50 and 80 years, six-month interval screening between age 40 and 80 years, and six-month interval screening between age 30 and 80 years. CONCLUSION: In Korea, a one-year screening interval for men aged 50 to 80 years would be marginally cost-effective. Further studies should be conducted in order to evaluate effectiveness of liver cancer screening, and compare the cost effectiveness of different liver cancer screening programs with a final outcome indicator such as quality-adjusted life-years or disability-adjusted life-years.
