2017-2020年江苏省扬州市上消化道癌症筛查的效果评价  

Evaluation of the effectiveness of upper gastrointestinal tract cancer screening in Yangzhou City,Jiangsu Province from 2017 to 2020

作　　者：缪子庭 姜鑫 丁岩冰[2] MIAO Zi-ting;JIANG Xin;DING Yan-bing(School of Yangzhou University,Yangzhou 225001,China;Department of Gastroenterology,the Affiliated Hospital of Yangzhou University,Yangzhou 225001,China)

机构地区：[1]扬州大学,225001 [2]扬州大学附属医院消化内科,225001

出　　处：《现代消化及介入诊疗》2022年第6期682-686,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：江苏省社会发展重点项目(BE2019698);扬州市“十三五”科教强卫专项(YXZX20184)。

摘　　要：目的评价对扬州市开展的2017-2020年上消化道肿瘤筛查的效果,以期为扬州市上消化道癌防治工作提供科学依据。方法选取2017—2020年参加上消化道癌筛查的40~79岁人群为研究对象,对其进行基线问卷调查、胃黏膜相关血清学检测、幽门螺杆菌检测、内窥镜检查和病理诊断等筛查流程,计算筛查顺应性、阳性病例检出率和早诊率,同时收集项目筛查及病例诊断治疗环节各种成本,开展卫生经济学评价。结果共纳入4919名筛查目标人群,其中4757例完成消化道内镜检查,筛查顺应性为96.71%,4716例完成病理活组织检查,病理检测率为95.87%。检出胃低级别上皮内瘤变154例(3.01%),胃高级别上皮内瘤变8例(0.17%),胃癌33例(0.70%),食管重度异型增生12例(0.25%),食管癌12例(0.25%),共检出阳性病变65例,检出率为1.38%,其中早期病变20例,早诊率为30.77%。共投入筛查成本为1427818元,得出检出1例阳性病变患者的成本为21966.43元,检出1例早期病变患者的成本为71390.9元。结合2020年扬州市人均国内生产总值(gross domestic product,GDP)为132784元,计算早期发现成本系数(early detection cost index,EDCI)为0.54,EDCI<5,说明扬州市上消化道癌早诊早治筛查项目极具成本效果价值。结论扬州市上消化道癌早诊早治筛查项目成效显著,符合当地经济发展水平,具有良好的社会效益和经济效益。Objective Screening and early diagnosis and treatment of cancers of the upper gastrointestinal tract is one of the main directions of cancer prevention and control in China.The Affiliated Hospital of Yangzhou University has explored and carried out the screening of upper gastrointestinal cancer since 2017,and has completed the endoscopic screening of nearly 5,000 cases of upper gastrointestinal cancer.This study intends to analyze the 2017-2020 upper gastrointestinal cancer screening data carried out in Yangzhou,and evaluate its screening effect,in order to provide a scientific basis for the prevention and treatment of upper gastrointestinal cancer in Yangzhou.Methods People aged 40-79 years who participated in upper gastrointestinal cancer screening from 2017 to 2020 were selected as the study population.Screening process with baseline questionnaires,blood tests,H.pylori testing,endoscopy and pathology diagnosis to calculate screening compliance,positive case detection rate and early diagnosis rate.At the same time,we collected various costs of project screening and case diagnosis and treatment sessions to conducted health economics evaluation.Results A total of 4,919 screening target populations were included,of which 4,757 cases completed gastrointestinal endoscopy,with a screening compliance of 96.71%.Pathological biopsy was completed in 4,716 cases,and the pathological detection rate was 95.87%.A total of 154(3.01%)gastric low-grade intraepithelial neoplasia,8(0.17%)gastric high-grade intraepithelial neoplasia,33(0.70%)gastric cancer,12(0.25%)esophageal severe heterogeneous hyperplasia,and 12(0.25%)esophageal cancer were detected.A total of 65 positive lesions were detected,with a detection rate of 1.38%,including 20 cases of early lesions and an early diagnosis rate of 30.77%.The total cost invested in screening was 142,788,818,and the cost of detecting one patient with a positive lesion was found to be 21,966.43,and the cost of detecting one patient with an early lesion was 71,390.9.Combined with the fact

关 键 词：上消化道癌筛查 早诊早治 成本及效果评价 扬州市 

分 类 号：R735[医药卫生—肿瘤] R57[医药卫生—临床医学]