Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China
Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China
复制标题
DOI：
10.3748/wjg.v18.i20.2493
复制
发表时间：
2012-05-28
影响因子：
4.3
通讯作者：
Qiao, You-Lin
中科院分区：
文献类型：
--
作者：
Yang, Juan;Wei, Wen-Qiang;Qiao, You-Lin
目的：评估中国食管癌高危地区内镜筛查策略的成本效益。方法：采用基于马尔可夫模型的分析，比较12种内镜筛查策略的净现值（npv）和效益成本比（bcr）。策略根据目标筛查年龄、筛查频率和随访间隔而变化。模型参数收集自中国基于人群的研究、已发表的文献和监测数据。结果：与非筛查结果相比，假设10万受试者的所有策略都节省了生命年。在增量成本效益分析确定的五种主要策略中，50岁筛查一次的NPV（国际美元- 5500万美元）和BCR（2.52）最低。在40-70年之间，每隔5年筛查6次[即6次（40）f策略]产生了最高的NPV（1,9900万美元）和BCR（3.06）。与6次（40）f策略相比，在40-70岁之间以10年为间隔进行3次筛查，NPV相对较低，但BCR相同。结论：内镜下EC筛查在中国高危地区具有成本效益。决策者在选择合适的筛查策略时应考虑成本效益、人口接受程度和当地经济状况。(C) 2012年白石登。版权所有。
AIM: To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer (EC) in high-risk areas of China.METHODS: Markov model-based analyses were conducted to compare the net present values (NPVs) and the benefit-cost ratios (BCRs) of 12 EC endoscopic screening strategies. Strategies varied according to the targeted screening age, screening frequencies, and follow-up intervals. Model parameters were collected from population-based studies in China, published literatures, and surveillance data.RESULTS: Compared with non-screening outcomes, all strategies with hypothetical 100 000 subjects saved life years. Among five dominant strategies determined by the incremental cost-effectiveness analysis, screening once at age 50 years incurred the lowest NPV (international dollar-1$55 million) and BCR (2.52). Screening six times between 40-70 years at a 5-year interval [i.e., six times(40)f-strategy] yielded the highest NPV (1$99 million) and BCR (3.06). Compared with six times(40)f-strategy, screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV, but the same BCR.CONCLUSION: EC endoscopic screening is cost-beneficial in high-risk areas of China. Policy-makers should consider the cost-benefit, population acceptance, and local economic status when choosing suitable screening strategies. (C) 2012 Baishideng. All rights reserved.