使用HPV测试来查宫癌的好处和成本
Jeanne S Mandelblatt1, William F Lawrence, Sharita Mizell Womack
1Lombardi Cancer Center, 2233 Wisconsin Ave NW, Suite 317, Washington, DC 20007. mandelbj@georgetown.edu
JAMA
|May 4, 2002
概括
每两年进行一次的HPV和Pap测试,以合理的成本为宫癌查提供了显著的终身年益. 为查设定年龄限制有效地平衡了好处,并降低了整体医疗保健费用.
科学领域:
- 妇科瘤学 妇科瘤学
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 尽管已经建立了质量标准,但宫癌查的帕帕尼科劳 (Pap) 测试性能仍然不理想.
- 评估新查方式的成本效益对于优化公共卫生干预至关重要.
研究的目的:
- 进行与人类乳头瘤病毒 (HPV) 检测,帕普检测及其结合用于宫癌查相关的社会成本和利益的比较分析.
主要方法:
- 使用神经瘤自然史的模拟模型来估计社会成本和质量调整后的预期寿命.
- 评估了18种查策略,包括结合HPV和Pap检测,单独的Pap检测和单独的HPV检测,频率和停止年龄各不相同.
- 主要的结果指标是每个策略节省的按质量调整的寿命年 (QALY) 的折扣成本.
主要成果:
- 与单独的Pap检测相比,每两年一次的HPV和Pap检测联合查,直到死亡为每QALY76,183美元的增量成本节省了最大的生命年节省.
- 75岁终止查,获得了97.8%的终身查福利,每QALY的费用为70,347美元.
- 发现单独的HPV测试比单独的Pap测试更昂贵,因此占主导地位,尽管敏感性分析表明,在较低的HPV测试价格下,潜在的成本效益更高.
结论:
- 与单独的Pap检测相比,每两年进行一次HPV和Pap检测的查提供了一种具有成本效益的策略,可以提高预期寿命.
- 实施以年龄为基础的宫癌查限制是一个有效的方法,可以保持显著的健康益处,同时降低成本.
相关概念视频
01:30Cancer Vaccines
Cancer treatment vaccines are a rapidly evolving field that offers a promising approach to immunotherapy. Unlike traditional vaccines that prevent diseases, cancer treatment vaccines are designed to treat existing cancers by stimulating the immune system to recognize and attack cancer cells.
Cancer vaccines come in two categories: preventive (prophylactic) and treatment (active). Preventive vaccines, such as the Human Papillomavirus (HPV) vaccine, protect against viruses that cause certain...
Cancer vaccines come in two categories: preventive (prophylactic) and treatment (active). Preventive vaccines, such as the Human Papillomavirus (HPV) vaccine, protect against viruses that cause certain...
01:30Serum Laboratory Studies, Stool Test, Breath Test
Gastrointestinal (GI) diagnostic studies are pivotal in confirming, ruling out, diagnosing, or staging various diseases, including cancers. Following diagnosis, allocating time for discussions with the patient and providing informational resources is crucial. Diagnostic assessments of the GI tract often occur in outpatient settings like endoscopy suites or GI labs. Preparation for these tests may include dietary restrictions, fasting, liquid bowel preparations, laxatives, enemas, and the...