Cost Effectiveness of Colorectal Cancer Screening Strategies
Cost Effectiveness of Colorectal Cancer Screening Strategies
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DOI：
10.1177/107327481502200219
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发表时间：
2015-04-01
期刊：
影响因子：
2.6
通讯作者：
Kilgore, Meredith L.
中科院分区：
文献类型：
--
作者：
Patel, Shaan S.;Kilgore, Meredith L.
背景：有几种筛查试验可用于发现结直肠癌（CRC）并降低结直肠癌的发病率和死亡率。本综述的目的是确定目前的CRC筛查策略与未筛查的比较，以及不同策略的成本效益是否一致。方法：检索2007年5月至2014年2月期间发表的美国CRC筛查策略的成本-效果分析数据库。我们分析了粪便隐血、粪便免疫化学和粪便DNA测试以及乙状结肠镜检查、结肠镜检查和虚拟结肠镜检查的用途。对所回顾的每项研究中每种筛查策略与不筛查策略进行配对比较。还包括对每项研究报告的结果进行一系列配对比较。结果：与未筛查相比，本综述评估的所有CRC筛查策略都具有成本效益。对于哪种筛查策略最具成本效益存在分歧。然而，乙状结肠镜联合粪便血液检查总是单独占主导地位。比较结肠镜检查与粪便血液检查、乙状结肠检查或两者的研究结果好坏参半。结论：与不筛查相比，所有CRC筛查策略都更具成本效益。对于哪种筛查策略应该是首选方法，研究结果并不一致。
Background: Several screening tests are available to detect colorectal cancer (CRC) and reduce the incidence and mortality of CRC. The purpose of this review was to determine how current CRC screening strategies for CRC compare with no screening and whether agreement exists with regard to the cost effectiveness of different strategies.Methods: Databases were searched for cost-effectiveness analyses focused on CRC screening strategies in the United States and published between May 2007 and February 2014. We analyzed the uses of fecal occult blood, fecal immunochemistry, and stool DNA tests, as well as sigmoidoscopy, colonoscopy, and virtual colonoscopy. A paired comparison of each screening strategy with no screening across each of the studies reviewed was conducted. A series of paired comparisons of the results reported in each of the studies is also included.Results: When compared with no screening, all CRC screening strategies evaluated in this review were cost effective. There was disagreement as to which screening strategy was the most cost effective. However, sigmoidoscopy combined with fecal blood testing always dominated either strategy alone. Studies comparing colonoscopy with fecal blood testing, sigmoidoscopy, or both had mixed results.Conclusions: Compared with no screening, all CRC screening strategies are more cost effective. Study results disagree as to which screening strategy should be the preferred method.