Zhi Cai Liu

Publications (2)3.13 Total impact

• Article: Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China.

  Juan Yang, Wen-Qiang Wei, Jin Niu, Zhi-Cai Liu, Chun-Xia Yang, You-Lin Qiao
  [show abstract] [hide abstract]
  ABSTRACT: To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer (EC) in high-risk areas of China. Markov model-based analyses were conducted to compare the net present values (NPVs) and the benefit-cost ratios (BCRs) of 12 EC endoscopic screening strategies. Strategies varied according to the targeted screening age, screening frequencies, and follow-up intervals. Model parameters were collected from population-based studies in China, published literatures, and surveillance data. Compared with non-screening outcomes, all strategies with hypothetical 100,000 subjects saved life years. Among five dominant strategies determined by the incremental cost-effectiveness analysis, screening once at age 50 years incurred the lowest NPV (international dollar-I$55 million) and BCR (2.52). Screening six times between 40-70 years at a 5-year interval [i.e., six times(40)f-strategy] yielded the highest NPV (I$99 million) and BCR (3.06). Compared with six times(40)f-strategy, screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV, but the same BCR. EC endoscopic screening is cost-beneficial in high-risk areas of China. Policy-makers should consider the cost-benefit, population acceptance, and local economic status when choosing suitable screening strategies.
  World Journal of Gastroenterology 05/2012; 18(20):2493-501. · 2.47 Impact Factor
• Article: Estimating the costs of esophageal cancer screening, early diagnosis and treatment in three high risk areas in China.

  Juan Yang, Wen Qiang Wei, Jin Niu, Yu Tong He, Zhi Cai Liu, Guo Hui Song, De Li Zhao, You Lin Qiao, Chun Xia Yang
  [show abstract] [hide abstract]
  ABSTRACT: The incidence and mortality of esophageal cancer (EC) in some rural areas with poor health resources in China are the highest around the world. In these areas, screening programs for EC are conducted for prevention and control. However, costs associated with esophageal cancer screening have not been characterized in detail. This study is aimed to estimate the screening, early diagnosis and treatment costs of EC using micro-costing methods, which could provide basic cost inputs for further systematic health economic evaluation. Micro-costing methods were adopted to collect data on quantity and unit cost of used resources. Data was obtained from face-to-face interview with medical staff, local hospitals' database, and experts' input. We used 80% capacity utilization and 3% discount rate to annualize capital investments, and all costs were adjusted to year 2008 using the gross domestic production deflator, and then converted from Chinese currency unit to international dollars (I$) using purchasing power parity. Screening costs per case were around I$60. For severe dysplasia, carcinoma in situ and intramucosal carcinoma, the costs per capita of endoscopic mucosal resection were I$1292~I$1620, and around I$450 for argon plasma coagulation. For submucosal carcinoma (T1N0M0), and invasive carcinoma treated by esophagectomy, the treatment costs ranged from I$1485 to I$2171. The costs of treatment of invasive carcinoma were: I$497~I$685.2 for radiotherapy; I$4652~I$7966.15 for chemotherapy; I$1928~I$2805 for combination of esophagectomy and radiotherapy; I$6632~I$8082 for esophagectomy, radiotherapy and chemotherapy in combination. The cost analysis found screening, early diagnosis and treatment for EC could provide great cost savings. The results provide important information for further health economic evaluation, and to help the local policy makers on updating such screening program in high risk areas in China.
  Asian Pacific journal of cancer prevention: APJCP 01/2011; 12(5):1245-50. · 0.66 Impact Factor