ArticleJNCI cancer spectrum2026
Cost-effectiveness of liquid biopsy screening for gastric cancer in the United States.
Article in JNCI cancer spectrum, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDespite the frequent late-stage diagnosis of gastric cancer (GC), the United States lacks a routine GC 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 LB screening for GC in the United States.
methodsA Markov model was developed to compare no screening (current standard-of-care) and 2 LB-screening strategies. The study used a simulated cohort of 45-year-old individuals with average risk of GC. 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 ICER was < the US willingness-to-pay threshold of $100 000 per quality-adjusted-life-year gained.
resultsIn the base-case analysis, LB screening strategies were not cost-effective, with an ICER of $917 826 per QALY gained. Screening became cost-effective for high-risk subpopulations or when the per-test cost was approximately $89.
conclusionsThis 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.
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