4 Background: Gastric cancer is one of the most common malignant cancer in Korea as 33,000 new patients are being diagnosed annually. Department of Health and Human Services has performed cancer screening project that recommends adults over 40 years old get mandatorily gastrointestinal endoscopy or gastrography for the detection of early gastric cancer every two years for free. This contributes to the discovery of early gastric cancer. However, the effectiveness of gastric cancer screening project is often questioned due to the lack of accurate data of the difference in the medical expenses between early gastric cancer and advanced gastric cancer. This study was aimed to investigate that the detection of early gastric cancer can lead to a reduction in health care costs. Methods: For the patients with newly diagnosed with gastric cancer in nine medical institutions during December 1, 2011 to June 30, 2012, the cost of the initial treatment, a total of one-year costs related to gastric cancer, inpatient and outpatient visits, test costs according to the tumor stage were investigated using a retrospective analysis of the medical records. Results: The cost of the initial treatment ($1,877 USD, $7,749 USD, $8,020 USD, and $6,809 USD, respectively by stage; P=0.000) and a one-year care costs ($1,441 USD, $5,142 USD, $8,444 USD, and $24,950 USD, respectively by stage; P=0.008) were significantly lower in stage I as compared with stage II, stage III, and stage IV. The numbers of hospitalizations, outpatient visits and abdominal CT and PET-CT scans were also significantly fewer in stage I as compared with more advanced stages. There was no difference in the cost of the initial treatment and one year care costs associated with gastric cancer between stage II, III, and IV. Chemotherapy had no effect on the difference in medical expenses. In the treatment of gastric cancer, medical expenses was affected significantly by early stage, whether or not endoscopic resection and complications. Conclusions: Detection of early gastric cancer is valuable not only for the possibility of a complete cure, but also for the reduction of the medical costs that are responsible for the patients and national health insurance.
A myelodysplastic syndrome with early gastric cancer and early colon cancer : case report