J Gastric Cancer.  2018 Mar;18(1):82-89. 10.5230/jgc.2018.18.e7.

Early Detection is Important to Reduce the Economic Burden of Gastric Cancer

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea. kimss@catholic.ac.kr
  • 3Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Early detection of gastric cancer is important to improve prognosis. Early detection enables local treatment, such as endoscopic submucosal dissection (ESD). Therefore, we investigated whether early detection of gastric cancer could reduce healthcare costs by comparison according to stage and treatment modalities.
MATERIALS AND METHODS
Medical care costs were investigated according to tumor stage and initial treatment modality in 1,188 patients newly diagnosed with gastric cancer at 7 medical institutions from December 2011 to June 2012. Total medical care costs during the first-year after diagnosis (total first-year costs) were examined, including the costs of initial treatment, post-initial treatment, and inpatient and outpatient visits.
RESULTS
Stage I (75.3%) was the most common cancer stage. ESD was the second most common treatment following surgery. Total first-year costs increased significantly from stages I to IV. The costs of initial treatment and post-initial treatment were lowest in patients with stage I cancer. Among patients with stage I cancer, total first-year costs were significantly lower when treated by ESD; in particular, initial ESD treatment costs were much lower than others.
CONCLUSIONS
The cost of healthcare has increased significantly with increasing cancer stages. ESD can greatly reduce medical care costs of gastric cancer. Thus, early detection of gastric cancer is important to reduce healthcare costs.

Keyword

Stomach neoplasms; Endoscopic submucosal dissection; Healthcare costs; Cancer staging; Early detection of cancer

MeSH Terms

Delivery of Health Care
Diagnosis
Early Detection of Cancer
Health Care Costs
Humans
Inpatients
Neoplasm Staging
Outpatients
Prognosis
Stomach Neoplasms*

Figure

  • Fig. 1 Medical care costs according to cancer stage. Total first-year costs increased significantly from stage I through stage IV. Initial treatment and post-initial treatment costs were the lowest for stage I (“<” indicates a significant difference).

  • Fig. 2 Medical care costs according to initial treatment modality in stage I cases. Initial stage I treatment modalities included ESD, OP, and OP with adjuvant CTx. Total first-year costs for stage I cancer were significantly lower for ESD, and, particularly, initial ESD treatment costs were lower than those of the other treatment modalities (“<” indicates a significant difference).ESD = endoscopic submucosal dissection; OP = surgery; CTx = chemotherapy.

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