Endocrine Abstracts

Background: Thyroid cancer can be detected in early stage using ultrasonography, but there are also questions about the necessity of screening tests due to its relatively high survival and low recurrence rate compared to other cancers. In this study, a cost-effectiveness analysis of thyroid cancer was conducted for better patient selection with cases diagnosed by ultrasound, as well as cases diagnosed through the presence of symptoms.

Methods: For the analysis, Markov decision chain model were used. The post-diagnosis process for patients followed the guidelines recommended by the Korean Thyroid Association. Recurrence rates and death rates were analyzed based on 25,000 patients from our institution. The cost calculations for diagnosis and treatment followed the regulations set by the South Korean Ministry of Health and Welfare. Deterministic and probabilistic sensitivity analyses were performed to account for uncertainty in the model’s variables.

Results: The average cost of diagnosis and treatment for patients diagnosed with asymptomatic thyroid cancer using ultrasound was W=2,730,997 for 5 years and W=3,970,652 for 10 years after diagnosis. In the case of patients diagnosed based on symptoms, the average cost was W=3,970,652 for 5 years and W=5,116,628 for 10 years. In sensitivity analysis, the cost range for patients diagnosed using ultrasound was W=2,661,955 to W=2,758,116, while for patients diagnosed based on symptoms, it ranged from W=3,785,588 to W=3,877,687 for 5 years. The maximum incremental cost was W=1,215,732. A slight increase was observed in the maximum incremental cost between patients diagnosed using ultrasound and those diagnosed based on symptoms for 10 years, at W=1,274,846 (W=3,901,609-W=4,025,078 for patients diagnosed using ultrasound and W=5,060,500-W=5,176,455 for patients diagnosed based on symptoms).

Conclusion: Diagnosis using ultrasound for asymptomatic thyroid cancer offers advantages in terms of cost-effectiveness when compared to symptom-based diagnosis in Korea. Cost-effectiveness can vary due to differences in the cost of diagnosis and treatment in each country, making it essential to establish an optimized thyroid screening strategy for a specific population.