Cost-effectiveness outcomes of the national gastric cancer screening program in south korea

Eun Cho, Moon Hae Kang, Kui Son Choi, Mi Na Suh, Jae Kwan Jun, Euncheol Park

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: Although screening is necessary where gastric cancer is particularly common in Asia, the performance outcomes of mass screening programs have remained unclear. This study was conducted to evaluate cost-effectiveness outcomes of the national cancer screening program (NCSP) for gastric cancer in South Korea. Materials and Methods: People aged 40 years or over during 2002-2003 (baseline) were the target population. Screening recipients and patients diagnosed with gastric cancers were identified using the NCSP and Korea Central Cancer Registry databases. Clinical outcomes were measured in terms of mortality and life-years saved (LYS) of gastric cancer patients during 7 years based on merged data from the Korean National Health Insurance Corporation and National Statistical Office. We considered direct, indirect, and productivity-loss costs associated with screening attendance. Incremental cost-effectiveness ratio (ICER) estimates were produced according to screening method, sex, and age group compared to non-screening. Results: The age-adjusted ICER for survival was 260,201,000-371,011,000 Korean Won (KW; 1USD=1,088 KW) for the upper-gastrointestinal (UGI) tract over non-screening. Endoscopy ICERs were lower (119,099,000-178,700,000 KW/survival) than UGI. To increase 1 life-year, additional costs of approximately 14,466,000-15,014,000 KW and 8,817,000-9,755,000 KW were required for UGI and endoscopy, respectively. Endoscopy was the most cost-effective strategy for males and females. With regard to sensitivity analyses varying based on the upper age limit, endoscopy NCSP was dominant for both males and females. For males, an upper limit of age 75 or 80 years could be considered. ICER estimates for LYS indicate that the gastric cancer screening program in Korea is cost-effective. Conclusion: Endoscopy should be recommended as a first-line method in Korea because it is beneficial among the Korean population.

Original languageEnglish
Pages (from-to)2533-2540
Number of pages8
JournalAsian Pacific Journal of Cancer Prevention
Volume14
Issue number4
DOIs
Publication statusPublished - 2013 Jan 1

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Republic of Korea
Early Detection of Cancer
Stomach Neoplasms
Cost-Benefit Analysis
Endoscopy
Korea
Costs and Cost Analysis
Mass Screening
Upper Gastrointestinal Tract
Gastrointestinal Endoscopy
Survival
Health Services Needs and Demand
National Health Programs
Registries
Age Groups
Databases
Mortality
Population
Neoplasms

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology
  • Public Health, Environmental and Occupational Health
  • Cancer Research

Cite this

Cho, Eun ; Kang, Moon Hae ; Choi, Kui Son ; Suh, Mi Na ; Jun, Jae Kwan ; Park, Euncheol. / Cost-effectiveness outcomes of the national gastric cancer screening program in south korea. In: Asian Pacific Journal of Cancer Prevention. 2013 ; Vol. 14, No. 4. pp. 2533-2540.
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abstract = "Background: Although screening is necessary where gastric cancer is particularly common in Asia, the performance outcomes of mass screening programs have remained unclear. This study was conducted to evaluate cost-effectiveness outcomes of the national cancer screening program (NCSP) for gastric cancer in South Korea. Materials and Methods: People aged 40 years or over during 2002-2003 (baseline) were the target population. Screening recipients and patients diagnosed with gastric cancers were identified using the NCSP and Korea Central Cancer Registry databases. Clinical outcomes were measured in terms of mortality and life-years saved (LYS) of gastric cancer patients during 7 years based on merged data from the Korean National Health Insurance Corporation and National Statistical Office. We considered direct, indirect, and productivity-loss costs associated with screening attendance. Incremental cost-effectiveness ratio (ICER) estimates were produced according to screening method, sex, and age group compared to non-screening. Results: The age-adjusted ICER for survival was 260,201,000-371,011,000 Korean Won (KW; 1USD=1,088 KW) for the upper-gastrointestinal (UGI) tract over non-screening. Endoscopy ICERs were lower (119,099,000-178,700,000 KW/survival) than UGI. To increase 1 life-year, additional costs of approximately 14,466,000-15,014,000 KW and 8,817,000-9,755,000 KW were required for UGI and endoscopy, respectively. Endoscopy was the most cost-effective strategy for males and females. With regard to sensitivity analyses varying based on the upper age limit, endoscopy NCSP was dominant for both males and females. For males, an upper limit of age 75 or 80 years could be considered. ICER estimates for LYS indicate that the gastric cancer screening program in Korea is cost-effective. Conclusion: Endoscopy should be recommended as a first-line method in Korea because it is beneficial among the Korean population.",
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Cost-effectiveness outcomes of the national gastric cancer screening program in south korea. / Cho, Eun; Kang, Moon Hae; Choi, Kui Son; Suh, Mi Na; Jun, Jae Kwan; Park, Euncheol.

In: Asian Pacific Journal of Cancer Prevention, Vol. 14, No. 4, 01.01.2013, p. 2533-2540.

Research output: Contribution to journalArticle

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AU - Kang, Moon Hae

AU - Choi, Kui Son

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