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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
2009-07-07
Publisher
W J G PRESS
Citation
WORLD JOURNAL OF GASTROENTEROLOGY; Vol.15 25; 3153-3160
Keywords
Cost-effectivenessSecond primary colorectal cancerCancer survivorScreening
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-year-old 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 cost-effectiveness 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/life-year saved (LYS), and did not exceed $10000/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 $10500/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. (C) 2009 The WIG Press and Baishideng. All rights reserved.
ISSN
1007-9327
Language
English
URI
https://hdl.handle.net/10371/76294
DOI
https://doi.org/10.3748/wjg.15.3153
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College of Medicine/School of Medicine (의과대학/대학원)Family Medicine (가정의학전공)Journal Papers (저널논문_가정의학전공)
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