Author(s)
Tchoe H1, Kwon J2, Shin S3, Lee J4, Suh J5, Lee J6, Yu E5
1National Evidence-based Healthcare Collaborating Agency(NECA), Seoul, Korea, Republic of (South), 2Kyungpook National University, Daegu, Korea, Republic of (South), 3National Evidence based Health-care Collaborating Agency, Seoul, Korea, Republic of (South), 4Seoul National University Hospital, Seoul, Korea, Republic of (South), 5National Evidence based Healthcare Collaborating Agency, Seoul, Korea, Republic of (South), 6National Evidence-based Healthcare Collaborating Agency, Seoul, Korea, Republic of (South)
OBJECTIVES: Hepatocellular carcinoma (HCC) is the leading cause of death among people in their 40’s and 50’s in South Korea. To reduce the socioeconomic burden from liver cancer, the National Liver Cancer Surveillance Program (NLCSP) has been established since 2003. The purpose of this study was to evaluate the surveillance status, diagnostic accuracy, and survival of NLCSP for the high risk group of HCC. METHODS: We used the National Health Insurance Service claims data linked with NLCSP from 2005 to 2014. For diagnostic accuracy, sensitivity, specificity, and positive predictability values (PPV) were assessed based on whether the patients diagnosed with HCC within 6 months after undergoing NLCSP during the study period. In addition, the impact of the NLCSP on survival was examined using a log-rank test and Cox proportional hazards model. The survival period was defined as time from development of HCC to death. A lead-time bias that occurred due to NLCSP was adjusted for in the models. RESULTS: The annual NLCSP rate resulted that individuals undergoing NLCSP have increased consistently from 6.9% in 2005 to 41.2% in 2014 The sensitivity of the surveillance varied (from 33.4% to 74.9%) depending on the assessment criteria, and clinical opinion. There was no significant variation in the trend of diagnostic accuracy during study periods. The risk of mortality for patients who underwent NLCSP once within the 2 years prior to being diagnosed with HCC was 22.1% lower (HR: 0.779, 95% CI: 0.758-0.800) compared with the patients who did not participate in NLCSP CONCLUSIONS: This study highlights the mortality benefit in patients who underwent NLCSP, and the needs for the continuous improvements of NLCSP in South Korea. Although the annual surveillance rate increased during the study periods, the public health efforts to encourage the surveillance participation would be still required to maximize the effects of NLCSP.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PHS95
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Pricing Policy & Schemes, Public Health, Quality of Care Measurement
Disease
Gastrointestinal Disorders, Oncology
