Abstract
Cervical cancer, which is common in developing countries, is also a major health issue in Korea. Our aim was to evaluate the cost-effectiveness of Korea's National Cancer Screening Program (NCSP), implemented in 1999. The target population was Korean women 30 years or over who were invited to take part in the NCSP in 2002-2007. By merging NCSP records with Korean Central Cancer Registry data, patients diagnosed with cervical cancer who had been screened were assigned to a "screened group, " while patients diagnosed elsewhere were assigned to a "non-screened group. " Clinical outcomes were measured in terms of life-years saved (LYS), derived from 5-year mortality rates supplied by the Korean National Health Insurance Corporation and National Statistical Office. Direct and travel costs associated with screening were evaluated from the perspective of the payer, the NCSP. A diagnosis via screening was associated with 2.30 LYS, and the incremental cost-effectiveness ratio (ICER) estimate for screening was 7,581,679 KW/LYS (6,727 USD/LYS). ICER estimates were lower for older patients (≥ 50 years) than younger patients (4,047,033 KW/ LYS vs 5,680,793 KW/LYS). The proportion of early-stage cancers detected was 16.3% higher in the screened group. In light of Korea's per capita gross domestic product (32,272 USD in 2012), the current NCSP's incremental cost per LYS appears acceptable.
Highlights
The annual incidence of cervical cancer worldwide has increased by 0.6%, from 378,000 cases in 1980 to 454,000 cases in 2010 (Forouzanfar et al, 2011)
By merging National Cancer Screening Program (NCSP) records with Korean Central Cancer Registry data, patients diagnosed with cervical cancer who had been screened were assigned to a “screened group,” while patients diagnosed elsewhere were assigned to a “non-screened group.”
Clinical outcomes were measured in terms of life-years saved (LYS), derived from 5-year mortality rates supplied by the Korean National Health Insurance Corporation and National Statistical Office
Summary
The annual incidence of cervical cancer worldwide has increased by 0.6%, from 378,000 cases in 1980 to 454,000 cases in 2010 (Forouzanfar et al, 2011) It is one of the most common cancers in developing countries, and it represents a major health issue in Korea and Japan, economically developed Asian nations (Konno et al, 2008; Razak et al, 2013). In Korea, a National Cancer Screening Program (NCSP) including the Pap smear was established in 1999, and, since 2002, coverage has included all National Health Insurance (NHI) beneficiaries and Medical Aid recipients (Cho et al, 2013). Our aim was to evaluate the cost-effectiveness of Korea’s National Cancer Screening Program (NCSP), implemented in 1999. Results: A diagnosis via screening was associated with 2.30 LYS, and the incremental cost-effectiveness ratio (ICER) estimate for screening was 7,581,679 KW/LYS (6,727 USD/LYS). Conclusions: In light of Korea’s per capita gross domestic product (32,272 USD in 2012), the current NCSP’s incremental cost per LYS appears acceptable
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