Authors
Jeong Yun Yang, Alice Agyekum, Kevin J Rouse, Sheila D Rustgi, Chin Hur
Published in
JNCI cancer spectrum. Sep 08, 2026. Epub Sep 08, 2026.
Abstract
Despite the frequent late-stage diagnosis of gastric cancer (GC), the U.S. lacks a routine gastric cancer screening program. Liquid biopsy (LB), specifically blood-based tests, has emerged as a potential screening approach, but it is unclear whether such a strategy is cost-effective. We therefore evaluated the cost-effectiveness of liquid biopsy screening for GC in the U.S.
A Markov model was developed to compare no screening (current standard-of-care) and two liquid biopsy screening strategies. The study used a simulated cohort of 45-year-old individuals with average risk of gastric cancer. Primary model outcomes included life expectancy, quality-adjusted life-years (QALYs), total cost, and incremental cost-effectiveness ratios (ICERs). A strategy was considered cost-effective if the incremental cost-effectiveness ratio was less than the U.S. willingness-to-pay threshold of $100,000 per quality-adjusted-life-year gained.
In the base-case analysis, LB screening strategies were not cost-effective, with an incremental cost-effectiveness ratio of $917,826 per QALY gained. Screening became cost-effective for high-risk subpopulations or when the per-test cost was approximately $89.
This economic evaluation of LB for GC screening found that while LB strategies are effective in reducing cancer incidence and mortality, they are not cost-effective due to high test costs. Our findings could help inform the potential planning of future clinical validation studies for LB tests used for GC screening.
PMID:
42708613
Bibliographic data and abstract were imported from PubMed on 08 Sep 2026.
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