风险适应性结直肠癌查的有效性和成本效益:一项随机对照试验和建模分析
Hong-Da Chen1, Bin Lu2,3, Ju-Fang Shi4
1Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China. chenhongda@pumch.cn.
Military Medical Research
|November 25, 2025
概括
风险适应性结肠直肠癌 (CRC) 查显示效果与结肠镜检查和便免疫化学测试 (FIT) 相比,但参与和成本不同. 这种方法可以补充现有的策略,特别是对有限的卫生资源.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 存在有限的证据来比较风险适应性结直肠癌 (CRC) 查与成熟的方法,如结肠镜检查和便免疫化学测试 (FIT).
- 根据风险调整的查旨在平衡CRC查效率与医疗保健资源需求.
研究的目的:
- 将风险调整的CRC查结果与传统的结肠镜和年度FIT策略进行比较.
- 评估检测率,参与率,资源利用率和成本效益,在4轮查和15年内进行.
主要方法:
- 一种混合方法结合了来自TARGET-C随机对照试验 (RCT) 的现实数据与MIMIC-CRC微型模拟模型.
- 50-74岁的参与者被随机分配到结肠镜,年度FIT或风险调整查组.
- 根据风险调整的查使用了一个复合得分,用于高风险的转移到结肠镜和低风险的FIT.
主要成果:
- 在所有策略中观察到相似的先进瘤检测率 (2.3%-2.8%).
- 与结肠镜 (42.3%) 相比,FIT (99.8%) 和风险适应 (92.5%) 组的参与率最高.
- 结肠镜在现实世界遵守条件下最具成本效益,而风险适应查在完美遵守条件下最具成本效益.
结论:
- 根据风险调整的查,结肠镜检查和FIT在检测晚期瘤方面表现出类似的有效性.
- 这些战略在参与率,资源需求和成本效益方面存在显著差异.
- 根据风险调整的查提供了一个可行的补充方法,在资源有限的环境中尤其有利.
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