Cost-Effectiveness of liquid biopsy screening for gastric cancer in the United States

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ID: 327841
2026
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Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Reference Key
openalex_W7211935618 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Jeong Yun Yang, Alice Agyekum, Kevin J. Rouse, Sheila D. Rustgi, Chin Hur
Journal jnci cancer spectrum
Year 2026
DOI
10.1093/jncics/pkag090
URL
https://doi.org/10.1093/jncics/pkag090
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