Cancer Res Treat.  2014 Jul;46(3):223-233.

Cost-Effectiveness of Liver Cancer Screening in Adults at High Risk for Liver Cancer in the Republic of Korea

• Lee YH
• Choi KS
• Jun JK
• Suh M
• Lee HY
• Kim YN
• Nam CM
• Park EC
• Cho WH

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.

Keyword

Liver neoplasms; Screening; Cost-benefit analysis

MeSH Terms

Adult*
alpha-Fetoproteins
Cost-Benefit Analysis
Female
Humans
Korea
Liver Neoplasms*
Male
Mass Screening*
Republic of Korea*
Ultrasonography
alpha-Fetoproteins

Figure

• 

  Fig. 1. Expansion path graph of the most cost-effective strategies for liver cancer screening by combined ultrasonography and alpha-fetoprotein in Korean men and women.

Reference

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