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Cancer Res Treat. 2014 Jul;46(3):223-233. English. Original Article.
Lee YH , Choi KS , Jun JK , Suh M , Lee HY , Kim YN , Nam CM , Park EC , Cho WH .
National Cancer Control Institute, National Cancer Center, Goyang, Korea. kschoi@ncc.re.kr
Department of Social Medicine, College of Medicine, Dankook University, Cheonan, Korea.
Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea.
Department of Preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.
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.

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