新型非侵入性查测试对结肠直肠新生病的成本效益
Aasma Shaukat1, Theodore R Levin2, Peter S Liang1
1Division of Gastroenterology, NYU Grossman School of Medicine, New York, New York; Department of Medicine, VA New York Harbor Health Care System, New York, New York.
概括
便免疫化学测试 (FIT) 是最具成本效益的结直肠癌 (CRC) 查策略. 多目标便RNA (mt-sRNA) 测试在分子选择中提供了最大的临床益处,防止了更多的CRC病例和死亡.
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) 查对于早期检测和预防至关重要.
- 建议45岁以上的平均风险人群进行查.
- 评估各种CRC查方式的经济和健康影响至关重要.
研究的目的:
- 评估不同结直肠癌 (CRC) 查计划对经济和健康的影响.
- 为了比较多目标便RNA (mt-sRNA),多目标便DNA (mt-sDNA),基于血液 (cfDNA) 和便免疫化学测试 (FIT) 的策略.
- 评估查计划的有效性与没有查和结肠镜检查相比.
主要方法:
- 一个10年的马尔科夫模型模拟了CRC进展.
- 进行了mt-sRNA,mt-sDNA (Cologuard,Cologuard Plus),cfDNA (Shield) 和FIT的比较.
- 利用来自独立研究和CISNET模型的年龄加权灵敏度/特异性进行校准/验证.
主要成果:
- 在分子测试中,mt-sRNA检测到了最先进的腺瘤,并预防了最多的CRC病例/死亡.
- 在60%的坚持下,mt-sRNA与mt-sDNA和cfDNA相比显示出优越的CRC病例/死亡减少.
- 总体而言,FIT是最具成本效益的策略;在三年一次的分子测试中,mt-sRNA是最具成本效益的.
结论:
- FIT是预防CRC的最具成本效益的策略.
- mt-sRNA在真实世界的坚持水平上提供了分子查测试中最大的临床益处.
- mt-sRNA比其他CRC分子查策略更具成本效益.
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