Korean J Gastrointest Endosc.  2004 Jan;28(1):1-8.

Cost-Effectiveness Analysis of Colon Cancer Screening by Colonosopic Examination in Korea

• Han DS
• Park JY
• Yun HR
• Bae SC

Abstract

BACKGROUND/AIMS
The mortality of colon cancer is reduced by a proper screening test. Recently, colonoscopic screening was reported more cost-effective than stool occult blood test or sigmoidoscopy in America. In this study, we performed cost-effectiveness analysis of colonoscopy as a colon cancer screening test in Korea by using Markov model.
METHODS
A hypothetical population of 50 years of age divided into 2 groups. Markov model was applied to those with colonoscopic screening and consecutive polypectomy or without screening. The effect of screening test to the general health was expressed as quality-adjusted life years (QALYs). The variables during the screening test and treatment were regarded carefully by sensitivity analysis.
RESULTS
The mean cost estimates for colonoscopic exam was 75,164 won and colon cancer treatment was 10,867,177 won. From the analysis using Markov model, the mean cost required for the screening group was 166,717 won and 76,938 won for non-screening group. The QALY in screening group was 18.49. The incremental cost-effectiveness was 1,097,992 won/QALY. CONCULSIONS: Regular colonoscopic exam requires higher medical cost than non-screening group, with its property of reducing mortality from colorectal cancer, however, colonoscopy is a cost-effective means of colorectal cancer screening.

Keyword

Colonoscopy; Screening; Cost-effectiveness

MeSH Terms

Americas
Colon*
Colonic Neoplasms*
Colonoscopy
Colorectal Neoplasms
Korea*
Mass Screening*
Mortality
Occult Blood
Quality-Adjusted Life Years
Sigmoidoscopy