对无症状胃癌的成本有效的内镜查策略
Fumiaki Ishibashi1, Kosuke Okusa2
1International University of Health and Welfare Ichikawa Hospital, Department of Gastroenterology, Chiba, Japan.
Digestion
|June 5, 2025
概括
随着患病率的下降,每两年一次的食道胃管腺镜 (EGD) 对胃癌 (GC) 的查可能会变得成本效益较低. 使用血清学测试等替代方法进行风险分层查,为优化GC检测提供了更具成本效益的方法.
科学领域:
- 公共卫生 公共卫生
- 胃肠病学 胃肠病学
- 卫生经济学 卫生经济学
背景情况:
- 日本以人口为基础的查计划使用两年一次的食道胃管腺镜 (EGD) 检测胃癌 (GC) 在50岁以上的成年人中.
- 这一策略改善了早期的GC检测,但由于Helicobacter pylori感染率下降,长期有效性可能会降低.
- 在GC选中,成本效益评估对于资源分配至关重要.
研究的目的:
- 评估目前用于胃癌的EGD查策略的成本效益.
- 探索替代和优化查方法,以改变GC流行率和感染率为背景.
主要方法:
- 九项研究的综述,比较了不同的EGD查策略.
- 利用数学模拟模型,包括微模拟和宏模拟 (马尔科夫,决策树模型),以评估比较有效性和成本效益.
主要成果:
- 在高风险国家,两年一次的EGD查是有效的.
- 在低至中等风险人群中,将查间隔延长到≥3年可能是合理的.
- 使用替代方法 (如血清学测试) 的风险分层显示出更高的成本效益.
结论:
- 当前GC查实践的成本效益可能随着GC患病率的下降而下降.
- 优化EGD查策略是必要的,可能通过风险分层和调整查间隔.
- 需要进一步讨论以完善基于人口的GC查方法.
相关概念视频
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