title: Cost-effectiveness of liver cancer screening in adults at high risk for liver cancer in the republic of Korea.
abstract: OBJECTIVE
  This study was conducted in order to determine the most cost-effective strategy, in terms of interval and age range, forliver cancer screening in the high-risk population of Korea.
  
  
  METHODS
  A stochastic modelwas used to simulate the cost-effectiveness ofliver cancer screening by combined ultrasonography and alpha-fetoprotein testing when varying both screening intervals and age ranges. The effectiveness of these screening strategies in the high-risk population was defined as the probability of detecting preclinical liver cancer, and costwas based on the direct cost ofthe screening and confirmative tests. Optimal cost-effectiveness was determined using the incremental cost-effectiveness ratio.
  
  
  RESULTS
  Among the 36 alternative strategies, one-year or two-year interval screening for men aged between 50 and 80 years, six-month or one-year interval screening for men aged between 40 and 80 years, and six-month interval screening for men aged between 30 and 80 years were identified as non-dominated strategies. For women, identified non-dominated strategies were: one-year interval screening between age 50 and 65 years, one-year or six-month interval screening between age 50 and 80 years, six-month interval screening between age 40 and 80 years, and six-month interval screening between age 30 and 80 years.
  
  
  CONCLUSIONS
  In Korea, a one-year screening interval for men aged 50 to 80 years would be marginally cost-effective. Further studies should be conducted in order to evaluate effectiveness of liver cancer screening, and compare the cost effectiveness of different liver cancer screening programs with a final outcome indicator such as qualityadjusted life-years or disability-adjusted life-years.
authors.affiliation: National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Young Hwa
authors.initials: YH
authors.lastname: Lee
authors.forename: Kui Son
authors.initials: KS
authors.lastname: Choi
authors.forename: Jae Kwan
authors.initials: JK
authors.lastname: Jun
authors.forename: Mina
authors.initials: M
authors.lastname: Suh
authors.forename: Hoo-Yeon
authors.initials: HY
authors.lastname: Lee
authors.forename: Youn Nam
authors.initials: YN
authors.lastname: Kim
authors.forename: Chung Mo
authors.initials: CM
authors.lastname: Nam
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Park
authors.forename: Woo-Hyun
authors.initials: WH
authors.lastname: Cho