基于Markov模型的安徽省城市肺癌筛查卫生经济学评价研究  

Health Economics Evaluation of Urban Lung Cancer Screening in Anhui Province Based on Markov Modeling

作　　者：王莉 刘慧婷 钱立庭 魏东华 马艳玲 邹明明 王德斌[1] 柴静[1] WANG Li;LIU Huiting;QIAN Liting;WEI Donghua;MA Yanling;ZOU Mingming;WANG Debin;CHAI Jing(School of Health Management,Anhui Medical University,Hefei 230032,China;The First Affiliated Hospital of USTC(Anhui Provincial Hospital)/Anhui Provincial Cancer Hospital Office of Early Diagnosis and Treatment of Urban Cancer,Hefei 230031,China;The Second People's Hospital of Hefei,Hefei 230011,China)

机构地区：[1]安徽医科大学卫生管理学院,安徽合肥230032 [2]中国科学技术大学附属第一医院(安徽省立医院)/安徽省肿瘤医院城市癌症早诊早治办公室,安徽合肥230031 [3]合肥市第二人民医院,安徽合肥230011

出　　处：《中国肿瘤》2025年第2期132-137,共6页China Cancer

基　　金：安徽省自然科学基金(2208085MG189);国家城市癌症早诊早治项目。

摘　　要：[目的]分析安徽省城市肺癌筛查项目的成本效果和成本效用,为安徽省制定肺癌筛查政策提供建议。[方法]基于现场调研数据和文献数据,建立低剂量螺旋CT(low-dose computed tomography,LDCT)肺癌筛查干预的Markov决策模型。模拟不同干预下人群的发展情况,使用挽救的生命年(saved life years,LYS)、质量调整生命年(quality-adjusted life years,QALY)作为效果指标,对不同筛查策略进行成本效果、成本效用分析。成本数据以3%贴现率进行贴现。[结果] 1年1次、2年1次、3年1次、5年1次的筛查方案每挽救1个LYS或QALY均符合成本效果原则。其中,成本效果比与成本效用比最好的筛查策略均为2年1次LDCT肺癌筛查策略,每挽救1个LYS或QALY成本最少,分别为72 441.54、71 050.24元。[结论] LDCT肺癌筛查方案具有良好的成本效果,不同筛查频次的策略均为可选策略,最佳筛查策略为2年1次。[Purpose]To analyze the cost-effectiveness and cost-utility conducted on the lung cancer screening project in urban areas of Anhui Province,and to provide suggestions for the formulation of lung cancer screening policies in Anhui Province.[Methods]A Markov decision model for low-dose computed tomography(LDCT)lung cancer screening intervention was established based on on-site survey data and literature data.The development of the population under different interventions was simulated,using saved life years(LYS)and quality-adjusted life years(QALY)as effectiveness indicators,to conduct cost-effectiveness and cost-utility analyses of different screening strategies.Cost data were discounted at a 3%discount rate.[Results]The screening schemes of once a year,once every two years,once every three years,and once every five years all meet the cost-effectiveness principle for saving one LYS or QALY.Among them,the best screening strategy in terms of cost-effectiveness and cost-utility was the LDCT lung cancer screening strategy once every two years,with costs of 72441.54 CNY and 71050.24 CNY,respectively.[Conclusion]The LDCT lung cancer screening program demonstrates good cost-effectiveness,with strategies of different screening frequencies being viable options.The optimal screening strategy is screening once every two years.

关 键 词：低剂量螺旋CT 筛查 成本效果分析 成本效用分析 安徽 

分 类 号：R734.2[医药卫生—肿瘤]