对结肠直肠癌查测试的环境影响比较分析
Vivek A Rudrapatna1, Tzu An Wang2, Parsia Vazirnia3
1University of California, San Francisco.
medRxiv : the preprint server for health sciences
|January 27, 2025
概括
便免疫化学测试 (FITs) 是最环保的结直肠癌 (CRC) 查选项. 优先考虑FIT而不是结肠镜检查,可以显著减少医疗保健.
科学领域:
- 环境科学与公共卫生
- 进行比较生命周期评估.
- 医疗保健的可持续性 医疗保健的可持续发展
背景情况:
- 医疗保健对全球温室气体排放作出了重大贡献.
- 结肠直肠癌 (CRC) 查是美国广泛使用的医疗保健服务,为1.34亿成年人提供.
- 查选项包括每年一次便免疫化学测试 (FIT),每5年一次CT结肠镜 (CTC) 或每10年一次结肠镜检查.
研究的目的:
- 为了比较不同CRC选策略对环境的影响.
- 确定减少CRC查对环境的影响的机会.
- 评估优先考虑影响较小的查方法对人口健康的益处.
主要方法:
- 对FIT,CTC和结肠镜进行比较生命周期评估 (LCA).
- 在现场进行审计,以记录材料和能源消耗.
- ReCiPe 2016方法用于估计全球变暖潜力 (GWP) 和人类健康损害.
- 对于10年累积影响的马尔科夫奖励模型和不确定性分析的蒙特卡洛模拟.
主要成果:
- 基于FIT的查显示了最小的环境影响,比结肠镜有20%的优势,在灵敏度分析中强大.
- 在所有查测试中,通过汽车运输患者和工作人员是造成环境损害的主要原因.
- 优先考虑FIT而不是结肠镜检查,每十年可以获得约520万个根据残疾调整的寿命年 (DALY).
- 过渡到电动汽车可以将所有选测试的GWP降低15-20%.
结论:
- 付款人应优先考虑低风险患者的FIT,因为它们具有类似的疗效和安全性.
- 支持运输脱碳,远程医疗和环境产品声明的政府举措对于减少医疗保健对环境的影响至关重要.
- 对低风险人群的资源密集型预防策略需要仔细考虑,以避免潜在的伤害.
关键词:
气候变化 气候变化 气候变化结肠镜检查 结肠镜检查结肠直肠癌查 结肠直肠癌查计算机断层扫描 结肠镜 结肠镜便免疫化学试验全球卫生健康全球卫生健康全球变暖全球变暖温室气体排放量排放量 温室气体排放量排放量卫生经济学 卫生经济学医疗保健的可持续性生命周期评估 生命周期评估人口健康 人口健康更多相关视频
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