Cost-effectiveness of liver cancer screening in adults at high risk for liver cancer in the Republic of Korea

Young Hwa Lee, Kui Son Choi, Jae Kwan Jun, Mina Suh, Hoo Yeon Lee, Youn Nam Kim, Chung Mo Nam, Eun Cheol Park, Woo Hyun Cho

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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.

Original languageEnglish
Pages (from-to)223-233
Number of pages11
JournalCancer Research and Treatment
Volume46
Issue number3
DOIs
Publication statusPublished - 2014

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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