Cost-effectiveness of liver cancer screening

Cucchetti, Alessandro; Cescon, Matteo; Erroi, Virginia; Pinna, Antonio Daniele

doi:10.1016/j.bpg.2013.08.021

Cited by 40 publications

(27 citation statements)

References 40 publications

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“…With regard to HCC screening, a review of the economic literature suggested that biannual surveillance would be cost‐effective in populations where the yearly incidence is higher than 1.5%‐3.0% . In this review, all 14 studies except one were based on Markov models.…”

Section: Discussionmentioning

confidence: 73%

“…(47,48) With regard to HCC screening, a review of the economic literature suggested that biannual surveillance would be cost-effective in populations where the yearly incidence is higher than 1.5%-3.0%. (49) In this review, all 14 studies except one were based on Markov models. Overall cost-effectiveness results reported in the literature vary widely depending on the surveillance strategy and treatments chosen.…”

Section: Discussionmentioning

confidence: 99%

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Early detection and curative treatment of hepatocellular carcinoma: A cost‐effectiveness analysis in France and in the United States

et al. 2017

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Early detection and curative treatment of hepatocellular carcinoma: A cost‐effectiveness analysis in France and in the United States

et al. 2017

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“…Multiple cost-effectiveness studies have examined this question and have reported variable findings depending on the incidence as well as the characteristics of local health systems. 31 These analyses have not considered management of patients after the first treatment of HCC and this is a significant limitation as there are appreciable rates of both HCC recurrence and progression of liver disease after treatment with resection or radiofrequency ablation; this will significantly impact future morbidity and mortality. In the recently published NICE guidance a new health economic evaluation was undertaken.…”

Section: Predictable Harms Of Surveillancementioning

confidence: 99%

Surveillance for hepatocellular cancer

Roskilly

Rowe

2018

Clinical Medicine

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high in patients with cirrhosis who develop HCC. 8 Mortality data from the UK for HCC demonstrates that this is rising in parallel with the incidence rates of HCC such that in 2015 there were approximately 1,700 deaths due to HCC. Since cirrhosis is readily identified and the risk of HCC is known, regular surveillance testing using ultrasound scanning is proposed to identify HCC early and to facilitate curative treatment.9 This rationale is supported by many international guidelines for the management of patients with cirrhosis including the European Association for the Study of the Liver (EASL) and the American Association for the Study of Liver Diseases (AASLD), as well as by recent guidance issued by the National Institute for Health and Care Excellence (NICE). 10-12 However, the recommendation that patients with cirrhosis have regular surveillance for HCC is not universally accepted and the majority of patients do not receive surveillance. 13-15The imperative for surveillanceMany international authorities, including the AASLD and the EASL recommend that high risk groups are entered into surveillance programmes. This includes the majority of patients with cirrhosis but not those with advanced liver failure unless they are on the transplant waiting list. Patients with non-cirrhotic HBV infection and patients with HCV infection and advanced fibrosis (defined as fibrosis stage 3 [out of 4, where 4 is cirrhosis]) are also recommended to have surveillance due to the increased incidence of HCC in these groups. 11 Surveillance of individuals without cirrhosis will not be discussed further in this article. Surveillance relies on the ideal that if we detect early asymptomatic cancers, curative treatment options are available to these patients. These treatments include resection, transplantation and radiofrequency ablation, each of which can achieve 5-year survival rates near 70% for small lesions, <2.5 cm in diameter.9 Recurrent HCC is frequently observed after liver resection and ablation since the development of HCC is associated with the underlying cirrhosis and that cirrhosis is not treated or targeted by local therapies. Liver transplantation offers a real prospect of cure for these patients; however, in practice this option is limited in applicability due to comorbidity and limited in availability due to a shortage of donor organs. Current provision of surveillanceReports of HCC surveillance in patients with cirrhosis consistently show poor uptake and adherence to the published guidance. A UK survey confirmed these international findings and showed that current surveillance for HCC is poor, provision is ad hoc and there Hepatocellular carcinoma (HCC) is a common complication of cirrhosis. The incidence of HCC is rising and HCC-related mortality is rising in parallel such that there were more than 1,700 deaths in the UK in 2015. Since cirrhosis is a known risk factor for the development of HCC and early diagnosis is associated with improved outcomes, surveillance for the development of HCC using regular ultrasou...

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“…Accordingly, future cancer prevention and control efforts in Guangxi should focus on the elderly population, especially the middle-aged male population; targeted intervention and control measures should be taken in light of the different rates of cancer incidence between genders. In secondary prevention of cancer, the target population can be chosen in accordance with the age and sex distribution of cancers to improve the cost-effectiveness of screenings (Cucchetti et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Mortality of Major Cancers in Guangxi, China: Sex, Age and Geographical Differences from 1971 and 2005

Deng¹,

Long²,

Li³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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The incidence and mortality rates of liver and nasopharyngeal cancer in Guangxi province of China have always been among the highest in the world, and cancer is one of the major diseases that pose a threat to the health of residents in Guangxi. However, no systematic study has been performed to evaluate the time trends in the structure of cancer-related deaths and cancer mortality. In this study, we reveal sex, age and geography differences of cancers mortality between three death surveys (1971 to 1973, 1990 to 1992, and 2004 to 2005). The results show that the standardized mortality rate of cancer in Guangxi residents has risen from 43.3/100,000 to 84.2/100,000, the share of cancer deaths in all-cause deaths has increased from 13.3% to 20.7%, and cancer has become the second most common cause of death. The five major cancers, liver cancer, lung cancer, gastric cancer, nasopharyngeal cancer and colorectal cancer, account for 60% of all the cancer deaths. Cancers with growing mortality rates over the past 30 years include lung cancer, colorectal cancer, liver cancer and female breast cancer, of which lung cancer is associated with the sharpest rise in mortality, with a more than 600% rise in both men and women. Cancer death in Guangxi residents occurs mainly in the elderly population above 45 years of age, especially in people over the age of 65. The areas with the highest mortality rates for liver cancer and nasopharyngeal cancer, which feature regional high incidences, include Chongzuo and Wuzhou. Therefore, for major cancers such as liver cancer, lung cancer, gastric cancer, nasopharyngeal cancer and female breast cancer in Guangxi, we can select high-risk age groups as the target population for cancer prevention and control efforts in high-prevalence areas in a bid to achieve the ultimate goal of lowering cancer mortality in Guangxi.

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Cost-effectiveness of liver cancer screening

Cited by 40 publications

References 40 publications

Early detection and curative treatment of hepatocellular carcinoma: A cost‐effectiveness analysis in France and in the United States

Early detection and curative treatment of hepatocellular carcinoma: A cost‐effectiveness analysis in France and in the United States

Surveillance for hepatocellular cancer

Mortality of Major Cancers in Guangxi, China: Sex, Age and Geographical Differences from 1971 and 2005

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