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Cost-Effectiveness of Surveillance for Hepatocellular Carcinoma: A Systematic Review
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¼Àç°æ(Suh Jae-Kyung) - Çѱ¹º¸°ÇÀǷῬ±¸¿ø
ÃÖÇÏÁø(Tchoi Ha-Jin) - Çѱ¹º¸°ÇÀǷῬ±¸¿ø
¾çÀå¹Ì(Yang Jang-Mi) - Çѱ¹º¸°ÇÀǷῬ±¸¿ø
½Å»óÁø(Shin Sang-Jin) - Çѱ¹º¸°ÇÀǷῬ±¸¿ø
Abstract
Objectives: Hepatocellular carcinoma (HCC) is the sixth most common cancer and third most common cause of cancer-related death worldwide. Guidelines recommend surveillance for HCC in patients at high-risk based on cost-effectiveness evidence. The purpose of this study is to systemically review cost-effectiveness of HCC surveillance.
Methods: A systematic search (between January 1946 and September 2015) within Medline, Embase and Cochrane databases was performed with the MeSH terms of ¡®hepatocellular carcinoma¡¯ AND (¡®alpha-fetoprotein¡¯ OR ¡®ultrasound¡¯ OR ¡®magnetic resonance imaging¡¯), and an economic evaluation filter. In addition, we assessed the quality of the studies with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) criteria.
Results: Of the 352 articles, 16 met the established criteria for economic evaluation for HCC surveillance. The average quality of included studies assessed by the CHEERS criteria was high in general, however, only two studies properly described the population and methods used to elicit preference for outcomes. The majority (82.3%) of the studies applied the decision analytic models for economic analysis, and measured outcome as quality-adjusted life years (68.8%) for longer than 10 years (62.5%). The HCC surveillance with ultrasound and ¥á-fetoprotein was generally a cost-effective strategy, whereas the surveillance with either CT or MRI was not cost-effective in most studies. Also, the cost-effectiveness of the surveillance depends on the etiology or severity of the target population and HCC incidence.
Conclusion: From the systematic review of economic evaluation, the cost-effectiveness of HCC surveillance differed in terms of strategies including diagnostic tests and the characteristics of target population. These aspects should be considered when conducting the HCC surveillance to increase the economic efficiency.
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Hepatocellular carcinoma, Screening, Surveillance, Cost-benefit analysis
KMID :
1146320170050010049
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À¯È¿¼º°á°ú(Recomendation)
The HCC surveillance with ultrasound and ¥á-fetoprotein was generally a cost-effective strategy, whereas the surveillance with either CT or MRI was not cost-effective in most studies.