PURPOSE: We investigated the cost-effectiveness of a screening program for the early diagnosis and treatment of @entity157 ( @entity157 ) in @entity1575 @entity1 . An @entity157 screening program in @entity1575 @entity1 should be carried out when the @entity157 makes a major cause of @entity204 and considering that: 1) the diagnostic techniques should be highly sensitive and specific; 2) the overall cost of the screening program should not be too high; 3) @entity1 survival should be improved. MATERIAL AND METHODS: March, 1989, to November 1991, 324 Italian @entity1 with @entity1575 (201 @entity1 and 123 @entity1 ) whose age ranged 18-83 years (mean +/- SD: 57.2 +/- 11.9) were submitted to US examinations and serum @entity160 titration at six months' intervals. RESULTS: During the follow-up, 38 @entity1 (11.7%) developed @entity157 , with 4.3% incidence per follow-up year. The Cox model identified serum @entity160 , @entity1 -Pugh classes B and C and the male gender as independent risk factors for developing @entity157 . Only 22 of 38 @entity157 @entity1 (58%) were submitted to resection, orthotopic liver transplantation or local therapy. The 3-year survival of the 38 HCCs diagnosed during the follow-up is 37%. In all, 1800 US examinations and serum @entity160 titrations were carried out during this screening program, costing 219,600 US dollars/ @entity1 . Each @entity157 treated successfully (stable disease at 12 months) was diagnosed at a cost of 24,400 US dollars. CONCLUSIONS: Screening all @entity1575 @entity1 is a questionable approach because it is very expensive and its benefit in terms of @entity1 survival is poor. More targeted screening programs with definite risk factors should be tested for cost-effectiveness.

[Screening for the early diagnosis of XXXX : cost-effectiveness analysis].

@entity1 :: ('9606', 'Species') :: ['Child', 'women', 'patients', 'patient', 'men'] @entity160 :: ('174', 'Gene') :: ['alpha-fetoprotein'] @entity1575 :: ('MESH:D008103', 'Disease') :: ['liver cirrhosis'] @entity157 :: ('MESH:D006528', 'Disease') :: ['HCC', 'hepatocellular carcinoma'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity157 :: (MESH:D006528,Disease) :: ['hepatocellular carcinoma']
