Comparing upper gastrointestinal X-ray and endoscopy for gastric cancer diagnosis in Korea

Table 1 Characteristics of gastric cancer screening participants (2002-2004) n (%)

	Upper GI X-ray	Upper endoscopy	Total (%)
Year
2002	290 410 (75.0)	96 637 (25.0)	387 047 (100.0)
2003	393 217 (70.9)	161 736 (29.1)	554 953 (100.0)
2004	383 751 (68.3)	177 895 (31.7)	561 646 (100.0)
Total (%)	1 067 378 (71.0)	436 268 (29.0)	1 503 646 (100.0)

GI: Gastrointestinal.

Table 2 Results of gastric cancer screening (2003–2005)

	Upper GI X-ray (n)			Upper endoscopy (n)
	Cancer	No cancer	Total	Cancer	No cancer	Total
Positive	892	108 178	109 070	1041	16 105	17 146
Negative	1227	957 081	958 308	724	418 398	419 122
Total	2119	1 065 259	1 067 378	1765	434 503	436 268

Table 3 Estimated costs and effectiveness of gastric cancer screening programs

	Model I		Model II
	Upper GI X-ray	Upper endoscopy	Upper GI X-ray	Upper endoscopy
Probability of gastric cancer (n)	0.000836	0.002386	0.000836	0.002386
Unit cost, US$ (a)	44.37	40.33	37.14	40.33
Cost to detect one case of gastric cancer (a/n)	53 094.64	16 900.43	44 445.78	16 900.43
Reduction in cost to detect one case of gastric cancer		36 194.21		27 545.35

Model I: Including screening test costs and confirmation test costs, if the results of upper GI X-ray were abnormal; Model II: Including screening test costs only.

Table 4 Unit cost in 2008 for the gastric cancer screening tests

	Units	Cost in USD
Screening cost	Medical examination	$4.47
	Upper gastrointestinal X-ray	$32.67
	Upper endoscopy	$34.89
	Biopsy	$24.54
Confirmation cost		$70.73

Confirmation cost: the cost of endoscopic examination with biopsy when the results of the upper GI X-ray were positive (“suspicious” or “cancer”).