Table 2.
Detailed analysis of the incremental cost-effectiveness ratio (ICER) of endoscopic screening strategies for gastric cancer compared to no endoscopic screening for Asian Americans (males, females)
| Ethnic Group (Males) |
Screening Strategy* | Cumulative Cost ($USD) |
Incremental cost ($USD) |
Effectiveness (QALYs) |
Incremental effectiveness (QALYs) |
ICER** ($USD/QALY) |
|---|---|---|---|---|---|---|
| Japanese American | • No screening | 4,050 | — | 27.48 | — | — |
| • One-time EGD +/− surveillance | 7,425 | 3,374 | 27.53 | 0.05 | 69,012 | |
| • Biennial EGD | 26,355 | 18,931 | 27.37 | −0.16 | Abs Dominated^ | |
| Chinese American | • No screening | 4,023 | — | 27.49 | — | — |
| • One-time EGD +/− surveillance | 7,362 | 3,339 | 27.53 | 0.05 | 68,738 | |
| • Biennial EGD | 26,336 | 18,974 | 27.37 | −0.16 | Abs Dominated^ | |
| Korean American | • No screening | 4,778 | — | 27.38 | — | — |
| • One-time EGD +/− Surveillance | 8,807 | 4,028 | 27.43 | 0.06 | 70,740 | |
| • Biennial EGD | 27,136 | 18,330 | 27.28 | −0.15 | Abs Dominated^ | |
| Vietnamese American | • No screening | 3,914 | — | 27.51 | — | — |
| • One-time EGD +/− surveillance | 7,082 | 3,168 | 27.55 | 0.04 | 74,146 | |
| • Biennial EGD | 26,075 | 18,994 | 27.39 | −0.16 | Abs Dominated^ | |
| Filipino American | • No screening | 3,642 | — | 27.60 | — | — |
| • One-time EGD +/− surveillance | 6,395 | 2,753 | 27.63 | 0.03 | 88,190 | |
| • Biennial EGD | 25,589 | 19,193 | 27.46 | −0.17 | Abs Dominated^ | |
| Southeast Asian American | • No screening | 3,671 | — | 27.62 | — | — |
| • One-time EGD +/− surveillance | 6,446 | 2,775 | 27.65 | 0.03 | 83,850 | |
| • Biennial EGD | 25,822 | 19,376 | 27.48 | −0.17 | Abs Dominated^ | |
| Asian American, overall | • No screening | 4,188 | — | 27.46 | — | — |
| • One-time EGD +/− surveillance | 7,529 | 3,341 | 27.51 | 0.04 | 75,959 | |
| • Biennial EGD | 26,461 | 18,931 | 27.35 | −0.16 | Abs Dominated^ | |
| Ethnic Group (Females) |
Screening Strategy* | Cumulative Cost ($USD) |
Incremental cost ($USD) |
Effectiveness (QALYs) |
Incremental effectiveness (QALYs) |
ICER** ($USD/QALY) |
| Japanese American | • No screening | 4,113 | — | 27.47 | — | — |
| • One-time EGD +/− surveillance | 7,547 | 3,434 | 27.52 | 0.05 | 73,748 | |
| • Biennial EGD | 26,470 | 18,923 | 27.36 | −0.16 | Abs Dominated^ | |
| Chinese American | • No screening | 4,016 | — | 27.49 | — | — |
| • One-time EGD +/− surveillance | 7,350 | 3,334 | 27.54 | 0.05 | 68,257 | |
| • Biennial EGD | 26,325 | 18,975 | 27.37 | −0.16 | Abs Dominated^ | |
| Korean American | • No screening | 4,812 | — | 27.37 | — | — |
| • One-time EGD +/− Surveillance | 8,827 | 4,015 | 27.43 | 0.06 | 70,236 | |
| • Biennial EGD | 27,145 | 18,318 | 27.28 | −0.15 | Abs Dominated^ | |
| Vietnamese American | • No screening | 3,916 | — | 27.51 | — | — |
| • One-time EGD +/− surveillance | 7,085 | 3,168 | 27.55 | 0.04 | 74,306 | |
| • Biennial EGD | 26,078 | 18,993 | 27.39 | −0.16 | Abs Dominated^ | |
| Filipino American | • No screening | 2,484 | — | 27.74 | — | — |
| • One-time EGD +/− surveillance | 4,348 | 1,864 | 27.76 | 0.02 | 83,732 | |
| • Biennial EGD | 24,318 | 19,970 | 27.58 | −0.18 | Abs Dominated^ | |
| Southeast Asian American | • No screening | 3,665 | — | 27.62 | — | — |
| • One-time EGD +/− surveillance | 6,438 | 2,772 | 27.65 | 0.03 | 83,267 | |
| • Biennial EGD | 25,815 | 19,377 | 27.48 | −0.17 | Abs Dominated^ | |
| Asian American, overall | • No screening | 4,170 | — | 27.47 | — | — |
| • One-time EGD +/− surveillance | 7,509 | 3,338 | 27.51 | 0.04 | 74,329 | |
| • Biennial EGD | 26,444 | 18,936 | 27.35 | −0.16 | Abs Dominated^ |
Abbreviations: $USD = US dollars; QALY = quality adjusted life
*
In the biennial endoscopy screening strategy, the index EGD was bundled with colonoscopy for colorectal cancer screening at 50 years of age. Subsequent EGDs were performed as stand-alone procedures. Please see text for full descriptions of each strategy.
**
ICERs might not calculate directly because of rounding.
^
Absolutely dominated (“Abs Dominated”) describes scenarios in which the strategy is less effective and costlier.