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Cost-effectiveness of mass screening for dipstick hematuria in Japan

Clinical and Experimental Nephrology volume 26, pages 398–412 (2022)Cite this article

A Correction to this article was published on 02 February 2022

This article has been updated

Abstract

Background

Dipstick urine tests are a simple and inexpensive method for detecting kidney and urological diseases, such as IgA nephropathy and bladder cancer. The nationwide mass screening program, Specific Health Checkup (SHC), started in Japan in 2008 and targeted all adults between 40 and 74 years of age. Dipstick urine tests for proteinuria and glucosuria are mandatory as part of the SHC, but dipstick urine tests for hematuria are not. However, the dipstick hematuria test is often administered simultaneously with these mandatory tests by some health insurers. Hematuria is common in Japanese general screening participants, particularly elderly women, and the necessity of mass screening using the dipstick hematuria test has been discussed. This study aimed to evaluate the cost-effectiveness of mass screening for dipstick hematuria tests in addition to the SHC.

Methods

Using a decision tree and Markov modeling, we conducted a cost-effectiveness analysis from a Japanese societal perspective.

Results

Compared with the current SHC, mass screening for dipstick hematuria tests, in addition to the SHC, costs less and gains more, which means cost-saving. Similar findings were observed in the sex-specific analysis.

Conclusion

Our results suggest that mandating the dipstick hematuria test could be justifiable as an efficient use of finite healthcare resources. The results have implications for mass screening programs not only in Japan but worldwide.

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Change history

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Acknowledgements

We express our thanks to Ryoya Tsunoda, Yukiko Kai, and Yuko Aoki for their assistance with the medical cost calculations.

Funding

This work was supported by Practical Research Project for Renal Diseases, Japan Agency for Medical Research and Development, AMED (Grant number JP20ek0310010). This work was also supported by a Japanese Grant-in-Aid for Scientific Research (B) (Grant number 19H03865).

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Authors and Affiliations

  1. Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8577, Japan

    Reiko Okubo, Shu-Ling Hoshi & Masahide Kondo

  2. Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan

    Reiko Okubo & Kunihiro Yamagata

  3. Department of Laboratory, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan

    Reiko Okubo

  4. Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan

    Tomokazu Kimura & Hiroyuki Nishiyama

  5. Division of Nephrology and Hypertension, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan

    Koichi Asahi

  6. Okinawa Heart and Renal Association (OHRA), Naha, Okinawa, Japan

    Chiho Iseki & Kunitoshi Iseki

  7. Department of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan

    Shouichi Fujimoto

  8. Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Science, Niigata, Niigata, Japan

    Ichiei Narita

Authors
  1. Reiko Okubo
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  2. Shu-Ling Hoshi
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  4. Masahide Kondo
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  5. Koichi Asahi
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  6. Chiho Iseki
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  7. Shouichi Fujimoto
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  8. Ichiei Narita
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  9. Hiroyuki Nishiyama
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  10. Kunihiro Yamagata
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  11. Kunitoshi Iseki
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Contributions

Research idea and study design: RO, MK, KI; data acquisition: RO, SH, TK, MK, KA, CI, SF, IN, KY, KI; data analysis/interpretation: RO, SH, TK, MK; writing – original drafts: RO; writing – review and editing: SH, TK, MK, KA, SF, IN, HN, KY, KI.

Corresponding author

Correspondence to Masahide Kondo.

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Ethics approval was not required, because we only used published studies or secondary data.

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The original online version of this article was revised: "In the original publication, few errors were found in Figure 2c, Table 1 and Table3.

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Okubo, R., Hoshi, SL., Kimura, T. et al. Cost-effectiveness of mass screening for dipstick hematuria in Japan. Clin Exp Nephrol 26, 398–412 (2022). https://doi.org/10.1007/s10157-021-02170-0

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  • DOI: https://doi.org/10.1007/s10157-021-02170-0

Keywords

  • Cost-effectiveness
  • Mass screening
  • Dipstick hematuria test
  • IgA nephropathy
  • Bladder cancer