Fuxiao Li1, Xiang Li1, Chuanhai Guo1, Ruiping Xu2, Fenglei Li3, Yaqi Pan1, Mengfei Liu1, Zhen Liu1, Chao Shi1, Hui Wang1, Minmin Wang1, Hongrui Tian1, Fangfang Liu1, Ying Liu1, Jingjing Li1, Hong Cai1, Li Yang4, Zhonghu He5, Yang Ke6. 1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital and Institute, No. 52 Fucheng Rd, Beijing, 100142, People's Republic of China. 2. Anyang Cancer Hospital, Anyang, Henan Province, People's Republic of China. 3. Hua County People's Hospital, Anyang, Henan Province, People's Republic of China. 4. School of Public Health, Peking University, Beijing, People's Republic of China. 5. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital and Institute, No. 52 Fucheng Rd, Beijing, 100142, People's Republic of China. zhonghuhe@foxmail.com. 6. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital and Institute, No. 52 Fucheng Rd, Beijing, 100142, People's Republic of China. keyang@bjmu.edu.cn.
Abstract
BACKGROUND AND OBJECTIVE: Population-level endoscopic screening for esophageal cancer has been conducted in China for years. In this study, we aim to provide an updated and precise cost estimation for esophageal cancer screening based on a randomized controlled trial in a high-risk area in China. METHODS: We estimated the cost of esophageal cancer screening with chromoendoscopy using a micro-costing approach based on primary data of the ESECC (Endoscopic Screening for Esophageal Cancer in China) randomized controlled trial (NCT01688908) from a health sector perspective. Unit costs and quantities of resources were collected to obtain annual screening costs. The screening project was then theoretically expanded to a 10-year period to explore long-term trends of costs. Costs were adjusted to US dollars for the year 2018. RESULTS: In the ESECC trial, screening cost per endoscopy with a valid pathologic diagnosis was $196, accounting for 3.82% of the gross domestic product per capita in Hua County, and the costs for detecting one esophageal cancer and one early-stage esophageal cancer were $26,347 and $37,687, respectively. In conventional screening in which protocol-driven costs were excluded, costs as above were $134, $18,074, and $25,853. The cost for detecting one gastric cardia cancer or stomach cancer was nine times higher than detecting one esophageal cancer owing to low prevalences of the two cancers. In a simulated 10-year screening project, annual cost decreased notably over time. CONCLUSIONS: Despite the relatively low absolute cost, population-level endoscopic screening will still be a heavy burden on local government considering the socioeconomic conditions. Long-lasting programs would be less costly and population-level screening would make little sense in non-high-risk regions.
RCT Entities:
BACKGROUND AND OBJECTIVE: Population-level endoscopic screening for esophageal cancer has been conducted in China for years. In this study, we aim to provide an updated and precise cost estimation for esophageal cancer screening based on a randomized controlled trial in a high-risk area in China. METHODS: We estimated the cost of esophageal cancer screening with chromoendoscopy using a micro-costing approach based on primary data of the ESECC (Endoscopic Screening for Esophageal Cancer in China) randomized controlled trial (NCT01688908) from a health sector perspective. Unit costs and quantities of resources were collected to obtain annual screening costs. The screening project was then theoretically expanded to a 10-year period to explore long-term trends of costs. Costs were adjusted to US dollars for the year 2018. RESULTS: In the ESECC trial, screening cost per endoscopy with a valid pathologic diagnosis was $196, accounting for 3.82% of the gross domestic product per capita in Hua County, and the costs for detecting one esophageal cancer and one early-stage esophageal cancer were $26,347 and $37,687, respectively. In conventional screening in which protocol-driven costs were excluded, costs as above were $134, $18,074, and $25,853. The cost for detecting one gastric cardia cancer or stomach cancer was nine times higher than detecting one esophageal cancer owing to low prevalences of the two cancers. In a simulated 10-year screening project, annual cost decreased notably over time. CONCLUSIONS: Despite the relatively low absolute cost, population-level endoscopic screening will still be a heavy burden on local government considering the socioeconomic conditions. Long-lasting programs would be less costly and population-level screening would make little sense in non-high-risk regions.
Authors: Don Husereau; Michael Drummond; Stavros Petrou; Chris Carswell; David Moher; Dan Greenberg; Federico Augustovski; Andrew H Briggs; Josephine Mauskopf; Elizabeth Loder Journal: Value Health Date: 2013 Mar-Apr Impact factor: 5.725
Authors: C Martin Tammemagi; Paul F Pinsky; Neil E Caporaso; Paul A Kvale; William G Hocking; Timothy R Church; Thomas L Riley; John Commins; Martin M Oken; Christine D Berg; Philip C Prorok Journal: J Natl Cancer Inst Date: 2011-05-23 Impact factor: 13.506