• 作者：Pau Sort^a ; ^{sortjane@althaia.cat} ; Marco Antonio Á ; lvarez^a ; Anna Bargalló ; ^a ; Á ; lvaro Isava^a ; Marí ; a Muñ ; oz^a ; Francesc Porta^a ; Eva Rodrí ; guez^b ; Francesc Vida^a
• 关键词：Cirrosis hepá ; tica ; Hepatocarcinoma ; Cribado ecográ ; fico
• 刊名：Gastroenterolog铆a y Hepatolog铆a
• 出版年：2011
• 期刊代码：pca167_02105705
• 类别：med
• 出版时间：October 2011
• 卷：34
• 期：8
• 页码：519-523
• 文件大小：129 K

Introduction

Current clinical guidelines recommend biannual screening for hepatocarcinoma in cirrhotic patients; however, the cost of this preventive activity is unknown.

Objective

To determine the cost of ultrasound screening for hepatocarcinoma in patients with cirrhosis.

Patients and method

Data on patients diagnosed with liver cirrhosis in a population of 245,042 inhabitants were prospectively gathered. The screening tests performed and cases of hepatocarcinoma diagnosed during the annual follow-up were included in the analysis. The cost of these tests was calculated based on the tariffs paid by insurance companies for health coverage of civil servants.

Results

In 2009, there were 374 patients with cirrhosis; of these, 99 were aged > 80 years, with a performance status of >2 or associated comorbidities. During the annual follow-up, the remaining patients underwent a total of 602 visits (abdominal ultrasound, blood test), four contrast-enhanced computed tomography scans, nine magnetic resonance scans, two scintigraphies, four aspiration biopsies, four radiographs and six contrast ultrasound scans. In our environment, the total estimated cost of these procedures was 37,946 鈧? indicating that the cost of a screening program for hepatocellular carcinoma according to the above-mentioned selection criteria is 0.155 鈧?per inhabitant/year. If only cirrhotic patients suitable for screening are included, the annual cost of screening is 138 鈧?per patient.

Conclusion

The cost of an ultrasound screening program for hepatocarcinoma is 0.155 鈧?per inhabitant/year. These data should be taken into account when considering population-based screening programs.