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Modeling the Cost-effectiveness of Esophageal Cancer Screening in China.


ABSTRACT:

Background

This study aimed to examine the cost-effectiveness of one-time standard endoscopic screening with Lugol's iodine staining for esophageal cancer (EC) in China.

Methods

A Markov decision analysis model with eleven states was built. Individuals aged 40 to 69 years were classified into six age groups in five-year intervals. Three different strategies were adopted for each cohort: (1) no screening; (2) one-time endoscopic screening with Lugol's iodine staining with an annual follow-up for low-grade intraepithelial neoplasia (LGIN); and (3) one-time endoscopic screening with Lugol's iodine staining without follow-up. Quality-adjusted life-years (QALYs) indicated the effectiveness of the model. The incremental cost-effectiveness ratio (ICER) was used as the evaluation indicator. Sensitivity analysis was performed to assess the robustness of the model.

Results

One-time screening with follow-up was the undominated strategy for individuals aged 40-44 and 45-49 years, which saved USD 10,942.57 and USD 6611.73 per QALY gained compared to nonscreening strategy. For those aged 50-69 years, the nonscreening scenarios were undominated. One-time screening without follow-up was the extended dominated strategy. Compared to screening strategies without follow-up, all the screening strategies with follow-up were more cost-effective, with the ICER increasing from 299.57 USD/QALY for individuals aged 40-44 years to 1617.72 USD/QALY for individuals aged 65-69 years. Probabilistic sensitivity analysis (PSA) supported the results of the base case analysis.

Conclusions

One-time EC screening with follow-up targeting individuals aged 40-49 years was the most cost-effective strategy.

SUBMITTER: Li Y 

PROVIDER: S-EPMC7488134 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Modeling the Cost-effectiveness of Esophageal Cancer Screening in China.

Li Yuanyuan Y   Du Lingbin L   Wang Youqing Y   Gu Yuxuan Y   Zhen Xuemei X   Hu Xiaoqian X   Sun Xueshan X   Dong Hengjin H  

Cost effectiveness and resource allocation : C/E 20200910


<h4>Background</h4>This study aimed to examine the cost-effectiveness of one-time standard endoscopic screening with Lugol's iodine staining for esophageal cancer (EC) in China.<h4>Methods</h4>A Markov decision analysis model with eleven states was built. Individuals aged 40 to 69 years were classified into six age groups in five-year intervals. Three different strategies were adopted for each cohort: (1) no screening; (2) one-time endoscopic screening with Lugol's iodine staining with an annual  ...[more]

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