对于结肠直肠癌查的最佳停止年龄
Matthias Harlass1, Ronit R Dalmat2, Jessica Chubak3,4
1Department of Public Health, Erasmus University Medical Center, Rotterdam, South Holland, the Netherlands.
JAMA network open
|December 19, 2024
概括
最佳的结肠直肠癌 (CRC) 查年龄因性别,健康和查史等个人因素而异. 本研究确定了个性化的CRC查停止年龄,以提高成本效益和指导决策.
科学领域:
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
- 预防医学 预防医学
背景情况:
- 结肠直肠癌 (CRC) 查的好处,危害和成本因患者的特征而异.
- 之前关于CRC查终止的研究是假设的,缺乏现实数据.
- 对老年人来说,需要个性化查策略.
研究的目的:
- 根据性别,并发症和查史来确定停止CRC查的最佳年龄.
- 在老年人群中从成本效益的角度评估CRC查.
- 为了为临床指导方针和患者对CRC查的决策提供信息.
主要方法:
- 使用MISCAN-Colon微型模拟模型进行经济评估.
- 基于社区的CRC发病率和死亡率数据的模型验证.
- 模拟美国76-90岁成年人CRC查情景,根据性别和并发症而有所不同.
主要成果:
- 最佳的CRC查终止年龄因性别,并发症和先前查史而有显著差异.
- 年龄较大,男性性别,并发病率较高,以及最近的查降低了成本效益.
- 最佳停药年龄在结肠镜检查中为<76至86岁,在FIT检查中为<76至88岁.
结论:
- 根据患者的因素,CRC查终止年龄应该是个性化的.
- 随着年龄的增长,并发病率的增加和最近的查,查的成本效益会下降.
- 结果支持个性化的CRC查建议和知情的患者选择.
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