Screening for hepatocellular carcinoma in cirrhotic patients using abdominal ultrasonography and alpha-fetoprotein levels is widely practiced.
In this study, researchers from the United Stated evaluated its cost-effectiveness using a Markov decision model.
The team simulated several screening strategies in 40-year-old patients with chronic hepatitis C and compensated cirrhosis.
|Biannual alpha-fetoprotein and annual ultrasonography was the most efficacious strategy.|
|Alimentary Pharmacology and Therapeutics|
The researchers found that annual alpha-fetoprotein and ultrasonography was the least efficacious strategy. They calculated that the incremental cost-effectiveness ratio for this strategy was $23,043 per quality-adjusted life-year.
Biannual alpha-fetoprotein and annual ultrasonography is the most commonly used strategy in the United States. The team determined that this was more efficacious than the previous strategy. This had a cost-effectiveness ratio of $33,083 per quality-adjusted life-year versus annual alpha-fetoprotein and ultrasonography.
The team found that the most efficacious strategy was biannual alpha-fetoprotein and ultrasonography. However, this had a cost-effectiveness ratio of $73,789 per quality-adjusted life-year versus biannual alpha-fetoprotein and annual ultrasonography.
Biannual alpha-fetoprotein and annual computerized tomography screening resulted in a cost-effectiveness ratio of $51,750 per quality-adjusted life-year versus biannual alpha-fetoprotein and annual ultrasonography screening.
Dr Lin's team concluded that, "Screening for hepatocellular carcinoma is as cost-effective as other accepted screening protocols".
"Of the strategies evaluated, biannual alpha-fetoprotein/annual ultrasonography gives the most quality-adjusted life-year gain while still maintaining a cost-effectiveness ratio <$50 000/quality-adjusted life-year".
"Biannual alpha-fetoprotein/annual computerized tomography screening may be cost-effective".