Does the cancer screening reduce the cost of cancer?

Background: The economic burden of cancer is projected to grow, due to a tendency to increase in both morbidity and mortality of cancer in Japan. The "National Cancer Control Act" was enforced in 2007 and the target to improve cancer screening rate from around 20% to 50% in 5 years and to reduce mortality rate up to 20% was set up; hence the large amount of resources devoted for anti-cancer strategy can be rationalized socio-economically. Objective: The aims of this study are to find out whether the cancer screening program could reduce the social cost or not, and to evaluate its investment effect. Method: According to a Markov model, we developed system model which typifies prognosis of six main cancers was developed. The change in social spending when the screening rate improves by 1.5 to 3 times was computed using the system model. Results: When the screening cost and its accuracy are constant, the reduction effect of medical cost is found only in the male gastric cancer. In other five cancers, medical cost rather increases. On the other hand, if the reduction of screening cost, improvement in a discovery rate, and the earlier stage at the detection are realized, it can be expected the reduction effect of medical cost in all six cancers. In order to get the economic effect, the cost reduction of screening serves as an absolute condition in female stomach, colorectal, and lung cancers. In male stomach, colorectal and lung cancers, and in female breast and uterus cancers, improvement in accuracy was considered to be the most important. Conclusion: When developing public health measures to which cancer screening is urged, the improvement of cost performance and screening accuracy are essential from the viewpoint of medical economics.