Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jan 14, 2010; 16(2): 245-250
Published online Jan 14, 2010. doi: 10.3748/wjg.v16.i2.245
Comparing upper gastrointestinal X-ray and endoscopy for gastric cancer diagnosis in Korea
Hoo-Yeon Lee, Eun-Cheol Park, Jae Kwan Jun, Kui Son Choi, Myung-Il Hahm
Hoo-Yeon Lee, Eun-Cheol Park, Jae Kwan Jun, Kui Son Choi, National Cancer Control Research Institute, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, South Korea
Myung-Il Hahm, Department of U-Healthcare Management, College of Medical Science, SoonChunHyang University, 646 Eupnae-ri, Shinchang-myeon, Asan-si, Chungnam 336-745, South Korea
Author contributions: Lee HY was the main author of this paper; Park EC contributed to the concept and study design; Jun JK and Choi KS contributed to analysis and interpretation of thedata; Hahm MI contributed to drafting of the article and revised it critically for important intellectual content.
Supported by Grant No. 0710131 from the National Cancer Center Research Fund
Correspondence to: Eun-Cheol Park, MD, PhD, National Cancer Control Research Institute, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, South Korea. ecpark@ncc.re.kr
Telephone: +82-31-9202003 Fax: +82-31-9202189
Received: August 27, 2009
Revised: November 23, 2009
Accepted: November 30, 2009
Published online: January 14, 2010
Abstract

AIM: To compare the cost and accuracy of upper gastrointestinal (GI) X-ray and upper endoscopy for diagnosis of gastric cancer using data from the 2002-2004 Korean National Cancer Screening Program (NCSP).

METHODS: The study population included 1 503 646 participants in the 2002-2004 stomach cancer screening program who underwent upper GI X-ray or endoscopy. The accuracy of screening was defined as the probability of detecting gastric cancer. We calculated the probability by merging data from the NCSP and the Korea Central Cancer Registry. We estimated the direct costs of the medical examination and the tests for upper GI X-ray, upper endoscopy, and biopsy.

RESULTS: The probability of detecting gastric cancer via upper endoscopy was 2.9-fold higher than via upper GI X-ray. The unit costs of screening using upper GI X-ray and upper endoscopy were $32.67 and $34.89, respectively. In 2008, the estimated cost of identifying one case of gastric cancer was $53 094.64 using upper GI X-ray and $16 900.43 using upper endoscopy. The cost to detect one case of gastric cancer was the same for upper GI X-ray and upper endoscopy at a cost ratio of 1:3.7.

CONCLUSION: Upper endoscopy is slightly more costly to perform, but the cost to detect one case of gastric cancer is lower.

Keywords: Gastric cancer, Mass screening, Endoscopy, Early diagnosis, X-ray diagnosis