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What is the most cost-effective strategy to screen for second primary colorectal cancers in male cancer survivors in Korea?

Cited 5 time in Web of Science Cited 8 time in Scopus
Authors
Park, Sang Min; Kim, Sun-Young; Earle, Craig C; Jeong, Seung-Yong; Yun, Young Ho
Issue Date
2009-07
Publisher
Baishideng Publishing Group Co. Limited
Citation
WORLD JOURNAL OF GASTROENTEROLOGY Vol.15 No.25, pp. 3153-3160
Keywords
복합학Cost-effectivenessSecond primary colorectal
cancer
ScreeningCancer survivor
Abstract
AIM: To identify a cost-effective strategy of second
primary colorectal cancer (CRC) screening for cancer
survivors in Korea using a decision-analytic model.
METHODS: A Markov model estimated the clinical
and economic consequences of a simulated 50-yearold
male cancer survivors’ cohort, and we compared
the results of eight screening strategies: no screening,
fecal occult blood test (FOBT) annually, FOBT every
2 years, sigmoidoscopy every 5 years, double contrast
barium enema every 5 years, and colonoscopy every
10 years (COL10), every 5 years (COL5), and every
3 years (COL3). We included only direct medical costs,
and our main outcome measures were discounted lifetime costs, life expectancy, and incremental costeffectiveness
ratio (ICER).
RESULTS: In the base-case analysis, the non-dominated
strategies in cancer survivors were COL5, and COL3.
The ICER for COL3 in cancer survivors was $5593/lifeyear
saved (LYS), and did not exceed $10 000/LYS in
one-way sensitivity analyses. If the risk of CRC in cancer
survivors is at least two times higher than that in
the general population, COL5 had an ICER of less than
$10 500/LYS among both good and poor prognosis of
index cancer. If the age of cancer survivors starting
CRC screening was decreased to 40 years, the ICER of
COL5 was less than $7400/LYS regardless of screening
compliance.
CONCLUSION: Our study suggests that more strict
and frequent recommendations for colonoscopy such
as COL5 and COL3 could be considered as economically
reasonable second primary CRC screening strategies for
Korean male cancer survivors.
ISSN
1007-9327
Language
English
URI
http://hdl.handle.net/10371/81812
DOI
https://doi.org/10.3748/wjg.15.3153
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Journal Papers (저널논문_의학과)
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