Abstract
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.
Original language | English |
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Pages (from-to) | 2493-2501 |
Number of pages | 9 |
Journal | World Journal of Gastroenterology |
Volume | 18 |
Issue number | 20 |
DOIs | |
Publication status | Published - 28 May 2012 |
Externally published | Yes |
Bibliographical note
Publisher Copyright:© 2012 Baishideng. All rights reserved.
Keywords
- Cost-benefit analysis
- Endoscopy
- Esophageal cancer
- High-risk area
- Screening