Age at Initiation and Frequency of Screening to Prevent Esophageal Squamous Cell Carcinoma in High-risk Regions: an Economic Evaluation.
Cancer Prev Res (Phila)
; 13(6): 543-550, 2020 06.
Article
en En
| MEDLINE
| ID: mdl-32152149
ABSTRACT
The aim of this study was to identify the economic screening strategies for esophageal squamous cell carcinoma (ESCC) in high-risk regions. We used a validated ESCC health policy model for comparing different screening strategies for ESCC. Strategies varied in terms of age at initiation and frequency of screening. Model inputs were derived from parameter calibration and published literature. We estimated the effects of each strategy on the incidence of ESCC, costs, quality-adjusted life-year (QALY), and incremental cost-effectiveness ratios (ICERs). Compared with no screening, all competing screening strategies decreased the incidence of ESCC from 0.35% to 72.8%, and augmented the number of QALYs (0.002-0.086 QALYs per person) over a lifetime horizon. The screening strategies initiating at 40 years of age and repeated every 1-3 years, which gained over 70% of probabilities that was preferred in probabilistic sensitivity analysis at a $1,151/QALY willingness-to-pay threshold. Results were sensitive to the parameters related to the risks of developing basal cell hyperplasia/mild dysplasia. Endoscopy screening initiating at 40 years of age and repeated every 1-3 years could substantially reduce the disease burden and is cost-effective for the general population in high-risk regions.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_financiamento_saude
Asunto principal:
Simulación por Computador
/
Neoplasias Esofágicas
/
Esofagoscopía
/
Modelos Económicos
/
Detección Precoz del Cáncer
/
Carcinoma de Células Escamosas de Cabeza y Cuello
/
Carcinoma de Células Escamosas de Esófago
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Health_economic_evaluation
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Aspecto:
Patient_preference
Límite:
Aged80
País/Región como asunto:
Asia
Idioma:
En
Revista:
Cancer Prev Res (Phila)
Asunto de la revista:
NEOPLASIAS
Año:
2020
Tipo del documento:
Article
País de afiliación:
China