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Comparing endoscopy and upper gastrointestinal X-ray for gastric cancer screening in South Korea: a cost-utility analysis

Authors
 Hoo-Sun Chang  ;  Eun-Cheol Park  ;  Woojin Chung  ;  Chung Mo Nam  ;  Kui Son Choi  ;  Eun Cho  ;  Woo-Hyun Cho 
Citation
 ASIAN PACIFIC JOURNAL OF CANCER PREVENTION, Vol.13(6) : 2721-2728, 2012 
Journal Title
 ASIAN PACIFIC JOURNAL OF CANCER PREVENTION 
ISSN
 1513-7368 
Issue Date
2012
MeSH
Adult ; Aged ; Aged, 80 and over ; Cost-Benefit Analysis ; Early Detection of Cancer/economics* ; Endoscopy, Gastrointestinal/economics* ; Female ; Gastrointestinal Tract/diagnostic imaging ; Humans ; Male ; Mass Screening/economics* ; Middle Aged ; Quality-Adjusted Life Years ; Radiography ; Republic of Korea ; Stomach Neoplasms/diagnosis* ; Stomach Neoplasms/diagnostic imaging*
Keywords
Stomach neoplasms ; mass screening ; Endoscopy ; quality-adjusted life years ; Korea
Abstract
BACKGROUND: There are limited data evaluating the cost-effectiveness of gastric cancer screening using endoscopy or upper gastrointestinal x-ray in the general population. OBJECTIVE: To evaluate the cost- effectiveness of population-based screening for gastric cancer in South Korea by decision analysis. METHODS: A time-dependent Markov model for gastric cancer was constructed for healthy adults 30 years of age and older, and a deterministic sensitivity analysis was performed. Cost-utility analysis with multiple strategies was conducted to compare the costs and effects of 13 different screening alternatives with respect to the following eligibility criteria: age at the beginning of screening, screening interval, and screening method. The main outcome measurement was the incremental cost-effectiveness ratio. RESULTS: The results revealed that annual endoscopic screening from ages 50-80 was the most cost-effective for the male population. In the females, biennial endoscopy screening from ages 50-80 was calculated as the most cost-effective strategy among the 12 screening alternatives. The most cost-effective screening strategy may be adjustable according to the screening costs and the distribution of cancer stage at screening. The limitation was that effectiveness data were obtained from published sources. CONCLUSIONS: Using the threshold of $19,162 per quality-adjusted life year on the basis of the Korean gross domestic product (2008), as suggested by the World Health Organization, endoscopic gastric cancer screening starting at the age of 50 years was highly cost-effective in the Korean population. The national recommendation for gastric cancer screening should consider the starting age of screening, the screening interval, and the screening modality.
Files in This Item:
T201202904.pdf Download
DOI
22938448
Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Nam, Jung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Chang, Hoo Sun(장후선)
Chung, Woo Jin(정우진) ORCID logo https://orcid.org/0000-0003-2090-4851
Cho, Woo Hyun(조우현)
Cho, Eun(조은)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89655
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