Objective: Using the health economics methodology to assess the screening program on gastric cancer in Zhuanghe high risk area for gastric cancer, from 2001 to 2003 and to assess the feasibility on cost of the screening program and to provide a basis for the popularization of the two-time gastric cancer screening methodology.
Methods: Three major techniques of medical economics namely cost-effective analysis (CEA), cost-benefit analysis (CBA) and cost-utility analysis (CUA) were used to assess the screening program. The screening program was composed of two steps: (1) epidemiological survey and detection of blood pepsinogen; (2) gastroscopy and biopsy of membrane. 'Number of deaths reduced' was used to evaluate the effect during cost-effective analysis while cost-benefit analysis would include the evaluation on the direct cost and indirect cost, direct benefit and indirect benefit as well as the cost-benefit ratio (CBR). During CUA, a questionnaire of WHOQOL-BREF was used to assess the value of the utility while the number of quality adjusted life year (QALY) saved by the screening program was also computed. The direct cost of per saved QALY was also calculated.
Results: Dada from CEA showed that: investing every 8448 Yuan on screening program and treatment in Zhuanghe high risk area of gastric cancer, one gastric cancer patient could be avoided. Results from CBA showed that: direct cost was 1,260,000 Yuan while indirect cost was 40 621 Yuan with direct benefit as 101 500 Yuan and indirect benefit as 1 540 979 Yuan. The total cost however, was 1,300,621 Yuan with total benefit as 2,555,979 Yuan and CBR was 1:1.97. Data from CUA showed that: a total number of 331.44 QALY was saved, 11.43 QALY was saved by reducing one death, 3802 Yuan per QALY was saved in high risk area of gastric cancer, through this screening program.
Conclusion: The screening program of gastric cancer appeared to be an economic and society-beneficial measure regarding primary prevention in high risk area of gastric cancer. We also suggested that in the future, evaluations through health economics methodologies on different screening programs be carried out in the same population to solve the problem of comparability.