低收入和中等收入国家结直肠癌查的动态:来自泰国的建模分析
Peeradon Wongseree1, Zeynep Hasgul2, Borwornsom Leerapan3
1Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Preventive medicine
|September 3, 2023
概括
在泰国改善结肠直肠癌 (CRC) 查和症状评估,可以显著减少CRC死亡. 综合策略,特别是增加结肠镜检查能力,是拯救生命和预防疾病进展的最有效方法.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 卫生系统研究 卫生系统研究
背景情况:
- 低收入和中等收入国家在早期发现结直肠癌 (CRC) 方面面临重大挑战.
- 对护理的获取有限和结肠镜检查能力低,阻碍了及时的CRC诊断和治疗.
研究的目的:
- 评估在泰国加强早期CRC检测的战略.
- 在资源有限的环境中降低CRC进展和死亡率.
主要方法:
- 开发了一个系统动态模型来模拟CRC死亡和进展.
- 分析了改善查 (便免疫化学测试,结肠镜检查) 和症状评估的影响.
- 综合策略在当前和扩展的结肠镜能力下进行了评估.
主要成果:
- 如果没有干预,CRC的死亡和进展预计将增加. 仅通过改善查准入,到2032年就能预防约7000例死亡和约9000例病变的发生.
- 通过加强症状评估,到2032年可以预防约3.5万例死亡,而不会影响病情的进展.
- 综合策略可以预防约4万例死亡和约7万例进展;通过增加结肠镜检查能力,可以预防约5万例死亡和约3万例进展.
结论:
- 同时加强查和症状评估对于在短期内减少CRC死亡至关重要.
- 这些综合策略是必要的,直到结肠镜检查能力可以显著增加.
- 虽然在降低死亡率方面是有效的,但相对于以查为重点的干预措施而言,相结合的方法在预防CRC进展方面可能不是最佳的.
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