Cost Utility Analysis of National Cancer Screening Program for Gastric Cancer in Korea: A Markov Model Analysis
- 주제(키워드) Incremental Cost-Utility Ratio , Endoscopy , Sensitivity and Scenario Analysis , Gastrointestinal Cancer
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Bae, Seowoo; Lee, Hyewon; Her, Eun Young; Jun, Jae Kwan; Choi, Kui Son; Suh, Mina] Natl Canc Ctr, Natl Canc Control Inst, 24 Jungbalsan Ro,Western Tower 4,24 Jeongbalsan Ro, Goyang 10403, South Korea; [Bae, Seowoo; Ahn, Jeonghoon] Ewha Womans Univ, Dept Hlth Convergence, Seoul, South Korea; [Lee, Kyeongmin; Jun, Jae Kwan; Choi, Kui Son; Suh, Mina] Natl Canc Ctr, Grad Sch Canc Sci & Policy, Goyang, South Korea; [Kim, Joon Sung] Catholic Univ Korea, Incheon St Marys Hosp, Coll Med, Dept Internal Med,Div Gastroenterol, Seoul, South Korea; [Choi, Il Ju] Natl Canc Ctr, Ctr Gastr Canc, Goyang, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- 발행기관 KOREAN ACAD MEDICAL SCIENCES
- 발행년도 2025
- URI http://www.dcollection.net/handler/ewha/000000245845
- 본문언어 영어
- Published As https://doi.org/10.3346/jkms.2025.40.e43
- PubMed https://pubmed.ncbi.nlm.nih.gov/39962941
초록/요약
Background: The Korean National Cancer Screening Program (NCSP) for gastric cancer requires economic evaluation due to the low sensitivity of upper gastrointestinal series (UGIs) and the associated low cancer survival rate. This study aimed to ascertain the most cost-effective strategy for the NCSP. Methods: The hypothetical target population of this study was aged 40 years or older, and no actual participants were involved. Markov simulation models were constructed for 25 strategies, combinations of 1) screening methods (UGIs or endoscopy vs. endoscopy-only), 2) screening intervals (one, two, or three-year), and 3) upper age limit of screening (69, 74, 79 years old, or "no limit"). Costs, utility, and other input parameters were extracted from various databases and previous studies. Cost-utility, sensitivity, and scenario analyses were conducted. Results: The endoscopy-only strategy with a three-year interval with an upper age limit of 69 was the most cost-effective strategy with an incremental cost-utility ratio of KRW 13,354,106 per quality-adjusted life years. According to the probabilistic sensitivity analysis, the uncertainty of the result was significantly small. Scenario analysis is showed that as the screening rate increased, the endoscopy-only strategy saved more costs compared to the current NCSP. Therefore, it is important to maintain a high screening rate when altering the NCSP strategy. Conclusion: Endoscopy-only screening was more cost-effective method than UGIs for the NCSP. Furthermore, a three-year interval with an upper-age limit of 69 years was the most cost-effective strategy. Efforts to improve cost-effective screening guidelines will support the efficient use of medical resources. Additionally, maintaining a higher screening rate may maximize the impact of the modification in strategy on cost-effectiveness.
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