J Korean Acad Fam Med.  2002 Nov;23(11):1340-1347.

An Analysis of Cost-Effective Screening Interval for HCC in Korean Hepatitis B Virus Carriers

• Roh JH
• Lee SJ
• Choi JY
• Lee SN
• Shin YK

Abstract

BACKGROUND: The purpose of this study was to evaluate the cost-effectiveness of screening tests (AFP and US) for early detection of primary hepatocellular carcinoma (HCC) and its optimal screening interval in Korean hepatitis B virus carriers.
METHODS
Data relating to tumor incidence, efficacy of screening tests, tumour growth times and various cost for detecting HCC were obtained from reviews of Korean literature. Decision analysis technique was used to calculate the efficacy of these screening tests and screening interval.
RESULTS
When the doubling time of HCC was 6 months, the most cost-effective screening interval of each AFP and US was 6 months, respectively. The optimal screening intervals of AFP and US were 3 and 5 months for each, respectively, and 7 months for both when a detection rate of 80% was expected. These results were significantly altered when the different tumour growth times reported in other literatures were applied.
CONCLUSION
If the doubling time of HCC was 6 months, the optimal screening interval was 7 months on using both tests. Because the tumour doubling time alters the optimal screening interval, further evaluation on the doubling time of Korean hepatoma is needed.

Keyword

alpha-fetoprotein (AFP); ultrasonography (US); hepatocellular carcinoma (HCC); doubling time; decision analysis technique

MeSH Terms

Carcinoma, Hepatocellular
Decision Support Techniques
Hepatitis B virus*
Hepatitis B*
Hepatitis*
Incidence
Mass Screening*