基于风险的低剂量计算机断层扫描查瑞士肺癌的成本效益
Yuki Tomonaga1, Koen de Nijs2, Heiner C Bucher3
1Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
International journal of cancer
|October 4, 2023
概括
瑞士的肺癌查越来越具有成本效益,使用风险模型而不是包年标准. 55-80岁常吸烟者的基于风险的查,其PLCOm2012风险为1.6%,显示出更高的效率和降低死亡率.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 在瘤学瘤学.
背景情况:
- 计算机断层扫描 (CT) 查肺癌正在欧洲各地实施.
- 有效地选择个人进行查至关重要.
- 在欧洲范围内,风险模型与包年标准的成本效益需要进行彻底的评估.
研究的目的:
- 为瑞士评估包年和基于风险的肺癌查策略的成本效益.
- 为瑞士癌症查委员会 (CSC) 提供建议.
主要方法:
- 使用了MISCAN-肺部微显模拟模型.
- 对1940年至1979年出生的个人进行查的估计益处和危害.
- 评估了1512个不同年龄段,查间隔和吸烟要求的策略.
主要成果:
- 基于风险的查策略被发现比基于包装年的策略更具成本效益.
- 符合CSC建议的最有效策略:每两年对55-80岁的常吸烟者进行查,其PLCOm2012风险为1.6%.
- 这一策略将肺癌死亡率降低11.0%,每获得的质量调整寿命年 (QALY) 费用为19,341欧元.
结论:
- 在瑞士,基于风险的两年一次查 (年龄为55-80岁,PLCOm2012风险≥1.6%) 比基于包年一次查更有效.
- 对瑞士来说,具有成本效益的肺癌查政策是可行的.
- 这些发现支持基于风险的方法,以优化CT查的实施.
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