低剂量CT筛查肺癌的经济学评价研究进展及思考  

Review of economic evaluation of lung cancer screening with low-dose computed tomography

作　　者：赵瑾 李俊[2] 许慧琳[2] 李为希[2] 李晔 胡敏[1] ZHAO Jin;LI Jun;XU Hui-lin;LI Wei-xi;LI Ye;HU Min(School of Public Health,Fudan University,Shanghai 200032,China;Minhang District Center for Disease Control and Prevention,Shanghai 201101,China)

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]上海市闵行区疾病预防控制中心,上海201101

出　　处：《上海预防医学》2021年第4期280-286,295,共8页Shanghai Journal of Preventive Medicine

基　　金：国家重点研发计划重大慢病专项(2018YFC1312905);“闵行-复旦”康联体合作项目。

摘　　要：【目的】对近期国内外低剂量CT筛查肺癌的经济学评价研究进行分析与归纳,为中国肺癌筛查的经济学评价研究提供建议和参考。【方法】系统检索并分析2015-2019年国内外发表的低剂量CT筛查肺癌的经济学评价文献。【结果】根据文献纳入标准选入15篇肺癌低剂量CT筛查的文献,均为英文文献,研究多在欧美发达国家开展,绝大部分采用模型模拟结果,其中13项研究表明低剂量CT筛查肺癌与无筛查或X线胸片筛查肺癌相比具有成本效果,2项研究的结果显示不具有成本效果。【结论】现有的经济学评价证据表明,低剂量CT筛查肺癌具有成本效果,越来越多的研究使用微观模拟模型从个体层面进行评估。但低剂量CT筛查肺癌具有成本效果在发展中国家的证据尚不充分,有必要结合我国的肺癌筛查实践和本土化数据开展经济学评价研究。[Objective]To analyze recent economic evaluation studies of low-dose CT screening for lung cancer in order to provide recommendations for such economic evaluation in China.[Methods]A systematic search and analysis was conducted to identify articles on low-dose CT screening for lung cancer published from 2015 to 2019.[Results]According to the literature inclusion criteria,15 studies were included.Most of the studies were conducted in Europe,the United States and other developed countries.The majority adopted model simulation approaches.Low-dose CT screening was suggested to be cost-effective compared with no-screening or chest radiography for lung cancer in 13 studies.Only 2 studies showed no cost-effectiveness.[Conclusion]The latest evidence of economic evaluation shows that lowdose CT screening for lung cancer is cost-effective and has a more consistent result than previous reviews.Methodologically,use of microsimulation models is increasing for better economic evaluation at the individual level.However,evidence from developing countries is still insufficient.It is necessary to conduct economic evaluation in combination with the domestic practice of lung cancer screening and localized data.

关 键 词：肺癌 低剂量CT 筛查 经济学评价 

分 类 号：R197[医药卫生—卫生事业管理]