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Article: What is the most cost-effective population-based cancer screening program for Chinese women?

TitleWhat is the most cost-effective population-based cancer screening program for Chinese women?
Authors
Issue Date2007
PublisherAmerican Society of Clinical Oncology. The Journal's web site is located at http://www.jco.org/
Citation
Journal Of Clinical Oncology, 2007, v. 25 n. 6, p. 617-624 How to Cite?
AbstractPurpose: To develop a policy-relevant generalized cost-effectiveness (CE) model of population-based cancer screening for Chinese women. Methods: Disability-adjusted life-years (DALYs) averted and associated screening and treatment costs under population-based screening using cervical cytology (cervical cancer), mammography (breast cancer), and fecal occult blood testing (FOBT), sigmoidoscopy, FOBT plus sigmoidoscopy, or colonoscopy (colorectal cancer) were estimated, from which average and incremental CE ratios were generated. Probabilistic sensitivity analysis was undertaken to assess stochasticity, parameter uncertainty, and model assumptions. Results: Cervical, breast, and colorectal cancers were together responsible for 13,556 DALYs (in a 1:4:3 ratio, respectively) in Hong Kong's 3.4 million female population annually. All status quo strategies were dominated, thus confirming the suboptimal efficiency of opportunistic screening. Current patterns of screening averted 471 DALYs every year, which could potentially be more than doubled to 1,161 DALYs under the same screening and treatment budgetary threshold of US $50 million with 100% Pap coverage every 4 years and 30% coverage of colonoscopy every 10 years. With higher budgetary caps, biennial mammographic screening starting at age 50 years can be introduced. Conclusion: Our findings have informed how best to achieve allocative efficiency in deploying scarce cancer care dollars but must be coupled with better integrated care planning, improved intersectoral coordination, increased resources, and stronger political will to realize the potential health and economic gains as demonstrated. © 2007 by American Society of Clinical Oncology.
Persistent Identifierhttp://hdl.handle.net/10722/86586
ISSN
2015 Impact Factor: 20.982
2015 SCImago Journal Rankings: 9.204
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWoo, PPSen_HK
dc.contributor.authorKim, JJen_HK
dc.contributor.authorLeung, GMen_HK
dc.date.accessioned2010-09-06T09:18:51Z-
dc.date.available2010-09-06T09:18:51Z-
dc.date.issued2007en_HK
dc.identifier.citationJournal Of Clinical Oncology, 2007, v. 25 n. 6, p. 617-624en_HK
dc.identifier.issn0732-183Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/86586-
dc.description.abstractPurpose: To develop a policy-relevant generalized cost-effectiveness (CE) model of population-based cancer screening for Chinese women. Methods: Disability-adjusted life-years (DALYs) averted and associated screening and treatment costs under population-based screening using cervical cytology (cervical cancer), mammography (breast cancer), and fecal occult blood testing (FOBT), sigmoidoscopy, FOBT plus sigmoidoscopy, or colonoscopy (colorectal cancer) were estimated, from which average and incremental CE ratios were generated. Probabilistic sensitivity analysis was undertaken to assess stochasticity, parameter uncertainty, and model assumptions. Results: Cervical, breast, and colorectal cancers were together responsible for 13,556 DALYs (in a 1:4:3 ratio, respectively) in Hong Kong's 3.4 million female population annually. All status quo strategies were dominated, thus confirming the suboptimal efficiency of opportunistic screening. Current patterns of screening averted 471 DALYs every year, which could potentially be more than doubled to 1,161 DALYs under the same screening and treatment budgetary threshold of US $50 million with 100% Pap coverage every 4 years and 30% coverage of colonoscopy every 10 years. With higher budgetary caps, biennial mammographic screening starting at age 50 years can be introduced. Conclusion: Our findings have informed how best to achieve allocative efficiency in deploying scarce cancer care dollars but must be coupled with better integrated care planning, improved intersectoral coordination, increased resources, and stronger political will to realize the potential health and economic gains as demonstrated. © 2007 by American Society of Clinical Oncology.en_HK
dc.languageengen_HK
dc.publisherAmerican Society of Clinical Oncology. The Journal's web site is located at http://www.jco.org/en_HK
dc.relation.ispartofJournal of Clinical Oncologyen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAge Factorsen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAsian Continental Ancestry Group - statistics & numerical dataen_HK
dc.subject.meshBreast Neoplasms - epidemiology - prevention & controlen_HK
dc.subject.meshCohort Studiesen_HK
dc.subject.meshColonoscopy - economics - methodsen_HK
dc.subject.meshColorectal Neoplasms - epidemiology - prevention & controlen_HK
dc.subject.meshCost-Benefit Analysisen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHealth Care Costsen_HK
dc.subject.meshHong Kongen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMammography - economics - methodsen_HK
dc.subject.meshMass Screening - economics - organization & administrationen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMonte Carlo Methoden_HK
dc.subject.meshOccult Blooden_HK
dc.subject.meshPopulation Surveillanceen_HK
dc.subject.meshProbabilityen_HK
dc.subject.meshProgram Evaluationen_HK
dc.subject.meshQuality-Adjusted Life Yearsen_HK
dc.subject.meshRisk Assessmenten_HK
dc.subject.meshSurvival Analysisen_HK
dc.subject.meshUterine Cervical Neoplasms - epidemiology - prevention & controlen_HK
dc.subject.meshVaginal Smears - economics - methodsen_HK
dc.subject.meshWomen's Health - economicsen_HK
dc.titleWhat is the most cost-effective population-based cancer screening program for Chinese women?en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0732-183X&volume=25&issue=6&spage=617&epage=624&date=2007&atitle=What+is+the+most+cost-effective+population-based+cancer+screening+program+for+Chinese+women?en_HK
dc.identifier.emailLeung, GM:gmleung@hku.hken_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1200/JCO.2006.06.0210en_HK
dc.identifier.pmid17308266en_HK
dc.identifier.scopuseid_2-s2.0-33947605782en_HK
dc.identifier.hkuros126224en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33947605782&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume25en_HK
dc.identifier.issue6en_HK
dc.identifier.spage617en_HK
dc.identifier.epage624en_HK
dc.identifier.isiWOS:000244384000004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWoo, PPS=8426498200en_HK
dc.identifier.scopusauthoridKim, JJ=16067004400en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK

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