结直肠癌查在不同结直肠镜附着的场景下的成本效益:一个微观模拟研究
Weimiao Wu1,2, Juan Yang2, Yuting Tan3
1Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
BMJ public health
|May 28, 2025
概括
低结肠镜检查效率影响了中国结肠直肠癌查效率. 通过两样便免疫化学测试 (FIT) 进行风险评估是具有成本效益的,特别是改善了依从性.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 胃肠病学 胃肠病学
背景情况:
- 在中国,对结肠镜检查的遵守率低,大大降低了结肠直肠癌 (CRC) 查的效率和成本效益.
- 有效的查策略对于早期检测和改善患者结果至关重要.
研究的目的:
- 评估各种结肠直肠癌 (CRC) 初始查测试的成本效益.
- 评估不同结肠镜附着水平对查计划效率的影响.
主要方法:
- 一个微模拟模型将风险评分系统 (RSS) 与一个样本或两个样本便免疫化学测试 (FIT) 与当前的上海方法 (风险评估+两个样本FIT) 进行了比较.
- 该模型模拟了10万个年龄在50-74岁之间的个体,在不同的坚持水平下 (观察到90%).
- 计算了增量成本效益比率 (ICER),并进行了敏感性分析以确保稳定性.
主要成果:
- 综合两样FIT的风险评估在降低CRC发病率和死亡率方面表现出卓越的有效性,在坚持水平低于80%的情况下,CRC的发病率和死亡率降低了80%.
- 目前的方法 (风险评估+两样FIT) 已被证明是有效和具有成本效益的,ICER在可接受的门内.
- 增加结肠镜检查的坚持性改善了早期CRC检测,并提高了当前查方法的成本效益.
结论:
- 平行使用风险评估和两样FIT是中国CRC查的成本有效策略.
- 建议加强结肠镜检查的坚持,以进一步优化CRC查计划的有效性和成本效益.
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