2019-2021年海南省海口市45-74岁城市居民肺癌筛查结果及成本-效果分析  

Results of Lung Cancer Screening Among Urban Residents Aged 45~74 Years Old in Haikou City from 2019 to 2021 and Cost-Effectiveness Analysis

作　　者：张旭 华婧 范康琼 王定彬 苏良苹 刘韦淞 田冶[2] ZHANG Xu;HUA Jing;FAN Kangqiong;WANG Dingbin;SU Liangping;LIU Weisong;TIAN Ye(Tumor Registration and Early Diagnosis and Treatment Office of Hainan Cancer Prevention and Control Center,Haikou 570100,China;International School of Public Health and One Health,Hainan Medical University,Haikou 571199,China)

机构地区：[1]海南省肿瘤防治中心肿瘤登记及早诊早治办公室,海南海口570100 [2]海南医学院公共卫生与全健康国际学院,海南海口571199

出　　处：《中国肿瘤》2024年第6期492-497,共6页China Cancer

摘　　要：[目的]分析2019-2021年海口市城市居民肺癌筛查项目筛查结果和成本效果,为我国城市人群癌症筛查和相关卫生决策提供多角度参考依据。[方法]基于2019-2021年海口市肺癌筛查项目数据及成本资料,分析45~74岁城市居民肺癌高危率、依从性和病变检出率;测算直接成本、间接成本及疑似肺癌的早期发现成本系数(EDCI)等指标,评价肺癌筛查的成本效果。[结果]2019-2021年共31058人参与海口市高危风险评估问卷初筛,其中11594人评估为肺癌高危人群,高危率为37.33%,高危人群中7164人接受低剂量螺旋CT(LDCT)检查,依从率为61.79%。检出肺阳性结节372例(检出率为5.19%),疑似肺癌77例(检出率为1.07%)。2019-2021年肺癌筛查的总费用为2820868元,每例肺癌的平均筛查费用为393.76元。45~74岁居民中每检出1例肺阳性结节费用为7582.98元,每检出1例疑似肺癌的费用为36634.65元,EDCI为0.48;各年龄组中65~74岁组检出1例疑似肺癌的费用最低(24376.21元),其EDCI为0.32。[结论]LDCT筛查肺癌高危人群具有良好的成本效用价值,尤其在65~74岁年龄组更具筛查价值。[Purpose]To analyze the screening results and cost-effectiveness of lung cancer screening programs among urban residents in Haikou City from 2019 to 2021.[Methods]Based on the data and cost information from lung cancer screening programs in Haikou City from 2019 to 2021,the high-risk rate,compliance rate and lesion detection rate among urban residents aged 45~74 years old were analyzed.The direct cost,indirect cost and early detection cost index(EDCI)of suspected lung cancer were calculated;the cost-effectiveness of lung cancer screening was analyzed.[Results]From 2019 to 2021,a total of 31058 urban residents in Haikou City participated in the preliminary screening with the high-risk assessment questionnaire.A total of 11594 participants were identified as high-risk of lung cancer with a high-risk rate of 37.33%,of whom 7164 underwent low-dose CT scan(LDCT),with a compliance rate of 61.79%.Positive pulmonary nodules were detected in 372 cases with a detection rate of 5.19%and suspected lung cancer was detected in 77 cases with a detection rate of 1.07%.The total cost of lung cancer screening from 2019 to 2021 was 2820868 CNY with an average screening cost of 393.76 CNY per person.The cost of detecting one case of positive pulmonary nodules was 7582.98 CNY,the cost of detecting one case of suspected lung cancer was 36634.65 CNY with an EDCI was 0.48.Among all age groups,the lowest cost of detecting one case of suspected lung cancer was in the age group of 65~74 years old(24376.21 CNY)with an EDCI of 0.32.[Conclusion]LDCT screening for high-risk groups of lung cancer has good cost-effectiveness value,especially in the age group of 65~74 years old.

关 键 词：肺癌 筛查 低剂量螺旋CT成本-效果分析 

分 类 号：R734.2[医药卫生—肿瘤]