Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012:5:49-54.
doi: 10.2147/RMHP.S18677. Epub 2012 Jun 19.

Hepatocellular carcinoma: cost-effectiveness of screening. A systematic review

Matteo Ruggeri  1
Affiliations

Hepatocellular carcinoma: cost-effectiveness of screening. A systematic review

Matteo Ruggeri. Risk Manag Healthc Policy. 2012.

Abstract

Hepatocellular carcinoma (HCC) is one of the most common tumors worldwide. HCC is a potential target for cancer surveillance (or screening) as it occurs in well-defined, at-risk populations. Curative therapy is possible only for small tumors and screening strategy has been recommended by the US, Italian, and other international liver societies and is practiced widely, but its benefits are not clearly established. The objective of this study was to review the available evidence with respect to the cost-effectiveness of key technologies in the prevention HCC. The literature search was conducted with the support of PubMed. Firstly we selected articles by reading the abstracts. Secondly, we read the articles and the revision was further restricted, with the following as inclusion criteria: (1) full economic evaluation of HCC screening programs; (2) comparison between HCC techniques; (3) outcome measures expressed in terms of quality adjusted life years (QALY); (4) full text availability. The initial review of the literature yielded 346 articles. Of those, 288 were excluded at the first stage. Of those excluded, 108 did not meet the target, 106 did not present the cost analysis, 33 did not analyze the treatment of the disease, and in 41 the abstract was not available. Of the 58 included in the first step, seven examined the cost-effectiveness of different HCC screening techniques, seven investigated the cost-effectiveness of HCC screening versus no screening, and one looked at the cost-effectiveness of timing for HCC surveillance and monitoring, while 43 were about HBV vaccination and screening. We included only the seven articles examining the cost-effectiveness of different HCC screening techniques. In general, incidence is the key parameter which determines the cost-effectiveness of HCC screening. Discrepancies in the results exist when determining the type of technology to be used. Ultrasound (US) alone or in association with alpha fetoprotein (AFP) technology is likely to be the most cost effective and the use of computed tomography (CT) gives controversial results.

Keywords: HCC screening; economic evaluations; systematic review.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Results of the literature search.
See this image and copyright information in PMC

References

    1. El-Serag HB, Mason AC. Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med. 1999;340(10):745–750. - PubMed
    1. Chalasani N, Said A, Ness R, Hoen H, Lumeng L. Screening for hepatocellular carcinoma in patients with cirrhosis in the United States: results of a national survey. Am J Gastroenterol. 1999;94(8):2224–2229. - PubMed
    1. Sallie R. Screening for hepatocellular carcinoma in patients with chronic viral hepatitis: can the results justify the effort? Viral Hepatitis Rev. 1995;1:77–95.
    1. Deuson RR, Brodovicz KG, Barker L, Zhou F, Euler GL. Economic analysis of a child vaccination project among Asian Americans in Philadelphia. Arch Pediatr Adolesc Med. 2001;155(8):909–914. - PubMed
    1. Yiu-Kuen BD, Ching LL, Man FY. Natural history of hepatitis-related hepatocellular carcinoma. World J Gastroenterol. 2008;14(11):1652–1656. - PMC - PubMed

LinkOut - more resources