新兴的基于血液的测试对结直肠癌查的比较好处,负担和危害
Reinier G S Meester1,2, Andrew J Piscitello3, Joseph A Duimstra4,5
1Health Economics and Outcomes Research, Freenome Holdings, Inc, Brisbane, CA, United States.
Journal of the National Cancer Institute
|October 5, 2025
概括
对结直肠癌 (CRC) 的新血液测试显示出有希望. 年度检测提供与当前方法相比的好处,而较少频繁的查可能会增加吸收和人口益处.
科学领域:
- 在瘤学瘤学.
- 预防医学 预防医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 新出现的结肠直肠癌 (CRC) 血液检测可能会提高查遵守率.
- 与一些现有方法相比,这些测试对晚期癌前病变的敏感性较低.
- 需要进行评估,以确定这些血液测试是否符合美国预防服务工作组 (USPSTF) 的建议.
研究的目的:
- 评估基于血液的CRC查测试的好处,负担和危害.
- 为了比较血液测试与既定的查策略,如结肠镜检查和便测试.
- 为了确定血液测试是否符合USPSTF推标准.
主要方法:
- 复制了一个以前由USPSTF使用的决策分析模型.
- 该模型估计了终身益处 (避免了CRC病例/死亡,增加了生命年数),负担 (查,结肠镜检查) 和危害 (并发症).
- 分析包括与基准策略相比,每年,每两年和每三年进行血液检测,并进行敏感性分析以确定实际的遵守.
主要成果:
- 结肠镜在基准策略中产生了最高的效益.
- 基于便的策略提供了81%-88%的结肠镜的生命年 (LYG) 获得了更多的测试和程序.
- 每年的血液检测提供了85%-87%的LYG,而查负担则中等. 两年/三年一次的测试显示,随着利用率的增加,潜在的净人口益处.
结论:
- 每年进行血液检查的好处,负担和危害与当前的CRC查选项一致.
- 每两年和三年一次的血液检测值得考虑推,因为其利用率可能会增加.
- 血液检查可能是现有的CRC查策略的可行替代方案或辅助方案,特别是如果它们可以提高守度.
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