2009-2015年江苏省扬中市上消化道癌症筛查成本效果及效益分析  

Cost-effectiveness and cost-benefit analysis of upper gastrointestinal cancer screening in Yangzhong City, Jiangsu Province, from 2009 to 2015

作　　者：冯祥 华召来[1] 钱东福 周琴[1] 施爱武[1] 魏文强 周金意[4] Feng Xiang;Hua Zhaolai;Qian Dongfu;Zhou Qin;Shi Aiwu;Wei Wenqiang;Zhou Jinyi(Cancer Research Institution,Yangzhong People′s Hospital,Yangzhong 212200,China;School of Health Policy and Management,Nanjing Medical University,Nanjing 211166,China;Cancer Regisery Office,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Department of Chronic Non-communicable Disease Control and Prevention,Jiangsu Center for Disease Control and Prevention,Nanjing 210009,China)

机构地区：[1]江苏省扬中市人民医院肿瘤防治研究所,212200 [2]南京医科大学医政学院,211166 [3]国家癌症中心国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院肿瘤登记办公室,北京100021 [4]江苏省疾病预防控制中心慢性非传染病防治所,南京210009

出　　处：《中华预防医学杂志》2019年第11期1115-1118,共4页Chinese Journal of Preventive Medicine

基　　金：国家重点研发计划(2016YFC0901400);国家科技支撑计划(2006BAl02A15)。

摘　　要：目的 评价2009-2015年江苏省扬中市上消化道癌症筛查效果、效益.方法 于2009-2015年,以扬中市八桥镇、油坊镇及兴隆街道地区的31个上消化道癌高发村为研究地区,招募13 776名40~69岁居民为研究对象.采用内窥镜检查和病理诊断筛查上消化道癌症患病情况,通过成本-效果和成本-效益评价方法对现有筛查方案进行评价.结果 研究对象的年龄为(53.60±8.14)岁,男性占43.64%(6 012名).共筛查出上消化道各级病变502例,其中癌症100例(食管、胃/贲门早期癌62例,中晚期癌38例)、食管重度异型增生/原位癌为38例,胃、贲门高级别上皮内瘤变15例,检出率分别为0.73%、0.28%和0.11%;早诊率为75.16%(115/153).筛查发现1例癌前病变、早诊病例和阳性病例的成本分别为10 037.17、30 460.64、22 895.25元;2009-2015年的早期发现成本系数分别为0.52、0.56、0.48、0.48、0.21、0.30、0.26,效益成本比分别为3.41、2.77、2.66、2.58、4.99、3.12、3.48.结论2009-2015年扬中市上消化道癌筛查的效果和效益较好.Objective To evaluate the effectiveness and benefit of the upper gastrointestinal cancer screening in Yangzhong city, Jiangsu province, from 2009 to 2015. Methods From 2009 to 2015, 31 natural villages with high-incidence of upper gastrointestinal cancer were selected from Baqiao town, Youfang town and Xinglong sub-district in Yangzhong city. 13 776 residents aged 40 to 69 years old were recruited and screened for upper gastrointestinal cancer by using endoscopic examination and pathological diagnosis. Two economic evaluation methods, cost-effectiveness analysis and cost-benefit analysis, were performed to evaluate the current screening schemes. Results The mean age of all respondents were (53.60 ± 8.14) years old and the males accounted for 43.64% (6 012). A total of 502 cases of upper gastrointestinal tract lesions were detected, including 100 cases of cancer (62 cases of esophagus, gastric/cardiac early stage cancer, 38 cases of advanced stage cancer), 38 cases of severe esophageal hyperplasia/carcinoma in situ, and 15 cases of high-grade intraepithelial neoplasia in stomach/cardia, the detection rate was 0.73%, 0.28% and 0.11%, respectively;the early diagnosis rate was 75.16% (115/153). The cost of a precancerous lesion, a case diagnosed at the early stage and a positive case identified through the upper gastrointestinal cancer screening in Yangzhong City was 10 037.17, 30 460.64 and 22 895.25 RMB, respectively. The early detection cost index from 2009 to 2015 was 0.52, 0.56, 0.48, 0.48, 0.21, 0.30, and 0.26, respectively. The effectiveness-cost ratio from 2009 to 2015 was 3.41, 2.77, 2.66, 2.58, 4.99, 3.12, and 3.48, respectively. Conclusions The project of early diagnosis and treatment of upper gastrointestinal tract cancer in Yangzhong city has achieved good results and benefits.

关 键 词：食管 贲门 癌 成本及成本分析 费用效益分析 

分 类 号：R[医药卫生]