Cost-effectiveness analysis of colorectal cancer screening with stool DNA testing in intermediate-incidence countries.
Cost-effectiveness analysis of colorectal cancer screening with stool DNA testing in intermediate-incidence countries.
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DOI：
10.1186/1471-2407-6-136
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发表时间：
2006-05-24
期刊：
影响因子：
3.8
通讯作者：
Chen TH
中科院分区：
文献类型：
--
作者：
Wu GH;Wang YM;Yen AM;Wong JM;Lai HC;Warwick J;Chen TH
本研究的目的是比较粪便DNA检测筛查与其他工具筛查（每年一次粪便潜血检测，每5年一次的乙状结肠镜检查，每10年一次的结肠镜检查）或根本不筛查的成本效益。我们发展了一个马尔可夫模型来评估上述筛查策略在台湾50至75岁的一般人群。进行敏感性分析，以评估各种参数对筛查成本效益的影响。本研究采用第三方支付者的观点，并以每生命年节省13，000结雅的成本（大致相当于台湾2003年的人均GNP）作为评估该计划是否具有成本效益的上限比率。每三年、五年和十年进行一次粪便DNA检测，可以分别降低结直肠癌死亡率22%、15%和9%。与不筛查相比，每挽救一个生命年，相关的增量成本分别为9，794美元、9，335美元和7，717美元。粪便DNA检测策略的成本效益最低，每次粪便DNA检测的成本、诊断性结肠镜检查的转诊率、大腺瘤的患病率和折扣率是最具影响力的参数。在结直肠癌发病率低或中等的国家，粪便DNA检测的成本效益低于目前推荐的其他基于人群的筛查策略，特别是针对无症状受试者。
The aim of this study is to compare the cost-effectiveness of screening with stool DNA testing with that of screening with other tools (annual fecal occult blood testing, flexible sigmoidoscopy every 5 years, and colonoscopy every 10 years) or not screening at all. We developed a Markov model to evaluate the above screening strategies in the general population 50 to 75 years of age in Taiwan. Sensitivity analyses were performed to assess the influence of various parameters on the cost-effectiveness of screening. A third-party payer perspective was adopted and the cost of $13,000 per life-year saved (which is roughly the per capita GNP of Taiwan in 2003) was chosen as the ceiling ratio for assessing whether the program is cost-effective. Stool DNA testing every three, five, and ten years can reduce colorectal cancer mortality by 22%, 15%, and 9%, respectively. The associated incremental costs were $9,794, $9,335, and $7,717, per life-year saved when compared with no screening. Stool DNA testing strategies were the least cost-effective with the cost per stool DNA test, referral rate with diagnostic colonoscopy, prevalence of large adenoma, and discount rate being the most influential parameters. In countries with a low or intermediate incidence of colorectal cancer, stool DNA testing is less cost-effective than the other currently recommended strategies for population-based screening, particularly targeting at asymptomatic subjects.
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影响因子：
39.2
作者：
ACHKAR, E;CAREY, W
通讯作者：
CAREY, W
DOI：
10.1053/ejso.2002.1282
发表时间：
2002-12-01
期刊：
EUROPEAN JOURNAL OF SURGICAL ONCOLOGY
影响因子：
--
作者：
Blom, J;Lidén, A;Påhlman, L
通讯作者：
Påhlman, L
影响因子：
3.7
作者：
Ahlquist, DA
通讯作者：
Ahlquist, DA
影响因子：
2.5
作者：
Koshiji, M;Yonekura, Y;Yoshioka, K
通讯作者：
Yoshioka, K
影响因子：
29.4
作者：
Ahlquist, DA;Skoletsky, JE;Shuber, AP
通讯作者：
Shuber, AP