Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China

• Published in: World journal of gastroenterology : WJG 2012-05, Vol.18 (20), p.2493-2501
• Main Authors: Yang, Juan, Wei, Wen-Qiang, Niu, Jin, Liu, Zhi-Cai, Yang, Chun-Xia, Qiao, You-Lin
• Format: Article
• Language: English
• Subjects: China; Cost-Benefit Analysis; Early Detection of Cancer - economics; Esophageal Neoplasms - diagnosis; Esophageal Neoplasms - economics; Esophagoscopy - economics; Humans; Markov Chains; Original; 中国; 内镜; 净现值; 成本效益分析; 时间间隔; 检查; 风险; 食管癌
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v18.i20.2493

AIM：To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer（EC）in high-risk areas of China. METHODS：Markov model-based analyses were conducted to compare the net present values（NPVs）and the benefit-cost ratios（BCRs）of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data. RESULTS：Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV（international dollar-I$55 million）and BCR（2.52）.Screening six times between 40-70 years at a 5-year interval[i.e., six times（40）f-strategy]yielded the highest NPV（I$99 million）and BCR（3.06）.Compared with six times（40）fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR. CONCLUSION：EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.