人群结直肠癌筛检项目成本效果分析与评价  

Cost-effectiveness analysis on colorectal cancer screening program

作　　者：黄秋驰 叶丁[1] 蒋曦依 李其龙[2] 姚开颜[3] 王建炳[1] 金明娟[1] 陈坤[1] 

机构地区：[1]浙江大学公共卫生学院流行病与卫生统计学系,杭州310058 [2]嘉善县肿瘤防治所办公室,314100 [3]嘉善县肿瘤防治所肿瘤登记处,314100

出　　处：《中华流行病学杂志》2017年第1期65-68,共4页Chinese Journal of Epidemiology

基　　金：国家重点基础研究发展计划（973计划）（2015CB554003）

摘　　要：目的 以卫生经济学角度，探讨各年龄组人群结直肠癌筛检项目成本效果差异。方法 利用浙江省嘉善县结直肠癌筛检项目资料，计算各年龄组人群的筛检依从率和病例检出率，利用χ^2检验及趋势χ^2检验判断年龄组间的差别。通过对筛检项目成本进行统计，计算各年龄组的成本/效果比。结果 免疫化学粪便潜血试验阳性率及进展期腺瘤、结直肠癌和早期癌的检出率随年龄增长有上升趋势，早诊率随年龄增长有下降趋势。40-49岁组人群筛检成本/效果比最高，敏感性分析发现剔除该组后筛检成本/效果比将降低15%-30%。结论 从卫生经济学角度，结直肠癌筛检起始年龄推迟至50岁更有利于提高筛检效率。Objective To evaluate the cost-effectiveness of colorectal cancer screening program in different age groups from the view of health economics. Methods The screening compliance rates, detection rates in different age groups were calculated by using the data from colorectal cancer screening program in Jiashan county, Zhejiang province. The differences in indicator among age groups were analyzed with χ^2 test or trend χ^2 test. The ratios of cost to the number of case were calculated according to cost statistics. Results The detection rates of immunochemical fecal occult blood test （iFOBT） positivity, advanced adenoma and colorectal cancer and early stage cancer increased with age, while the early diagnosis rates were negatively associated with age. After exclusion the younger counterpart, the cost-effectiveness of individuals aged 〉50 years could be reduced by 15%-30%. Conclusion From health economic perspective, it is beneficial to start colorectal cancer screening at age of 50 years to improve the efficiency of the screening.

关 键 词：结直肠癌 筛检 成本效果分析 

分 类 号：R735.34[医药卫生—肿瘤]