Cost‐effectiveness analysis of colorectal cancer screening using colonoscopy, fecal immunochemical test, and risk score
Cost‐effectiveness analysis of colorectal cancer screening using colonoscopy, fecal immunochemical test, and risk score
复制标题
使用结肠镜检查、粪便免疫化学检测和风险评分进行结直肠癌筛查的成本效益分析
DOI：
10.1111/jgh.15033
复制
发表时间：
2020
影响因子：
4.1
通讯作者：
Matsuda Takahisa
中科院分区：
文献类型：
--
作者：
Sekiguchi Masau;Igarashi Ataru;Sakamoto Taku;Saito Yutaka;Esaki Minoru;Matsuda Takahisa
背景和目的风险分层评分可能有助于结直肠癌（CRC）筛查，以及筛查结肠镜检查（CS）和粪便免疫化学试验（FIT）。本研究旨在评估使用CS、FIT和日本CRC筛查评分的基于人群的CRC筛查策略的有效性和成本效益。（策略1）、FIT（策略2）和风险评分（策略3），使用两种场景的模拟模型分析。在场景1中，所有测试的吸收率为60%。在场景2中，摄取率为FIT和风险评分为40%，和那些筛选CS和CS后，积极的FIT或高风险评分分别为20%和70%.ResultsIn场景1，策略1获得了最高的QOLS，并需要最高的成本。策略1相对于其他策略获得的每QALY增量成本效益比低于500万日元。策略1需要的CS程序是其他策略的两倍多。在场景2中，策略3具有最高的QHOS和最低的成本，策略1具有最低的QHOS和最高的cost.ConclusionsScreening CS有可能成为最有效和最具成本效益的形式CRC筛查，虽然它需要大量的CS程序。然而，如果受试者更喜欢非侵入性检查，其他筛查策略，特别是使用风险评分的策略，可能更有效，更具成本效益。
Background and AimA risk‐stratification score may be useful for colorectal cancer (CRC) screening, alongside screening colonoscopy (CS) and fecal immunochemical test (FIT). This study aimed to evaluate the effectiveness and cost‐effectiveness of population‐based CRC screening strategies using CS, FIT, and the Japanese CRC screening score.MethodsThe effectiveness in quality‐adjusted life years (QALYs), cost‐effectiveness, and required number of CS procedures were evaluated for screening strategies with primary screening CS (strategy 1), FIT (strategy 2), and the risk score (strategy 3), using a simulation model analysis with two scenarios. In scenario 1, uptake rates for all tests were 60%. In scenario 2, uptake rates for FIT and a risk score were 40%, and those for screening CS and CS following a positive FIT or high risk score were 20% and 70%, respectively.ResultsIn scenario 1, strategy 1 gained the highest QALYs and required the highest cost. The incremental cost‐effectiveness ratios per QALY gained for strategy 1 against the others were lower than 5 000 000 JPY. Strategy 1 required more than twice as many CS procedures as the other strategies. In scenario 2, strategy 3 had the highest QALYs and lowest cost, and strategy 1 had the lowest QALYs and highest cost.ConclusionsScreening CS has the potential to be the most effective and cost‐effective form of CRC screening, although it requires a large number of CS procedures. However, if non‐invasive tests are preferred by recipients, other screening strategies, particularly those using the risk score, can be more effective and cost‐effective.
登录
查看更多内容
DOI：
10.1056/nejmoa1301969
发表时间：
2013-09-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
Nishihara R;Wu K;Lochhead P;Morikawa T;Liao X;Qian ZR;Inamura K;Kim SA;Kuchiba A;Yamauchi M;Imamura Y;Willett WC;Rosner BA;Fuchs CS;Giovannucci E;Ogino S;Chan AT
通讯作者：
Chan AT
影响因子：
12.6
作者：
Kahi, Charles J.;Imperiale, Thomas F.;Rex, Douglas K.
通讯作者：
Rex, Douglas K.
影响因子：
6.3
作者：
Tanaka, Shinji;Saitoh, Yusuke;Shimosegawa, Tooru
通讯作者：
Shimosegawa, Tooru
影响因子：
29.4
作者：
Leggett, Barbara;Whitehall, Vicki
通讯作者：
Whitehall, Vicki
基于年龄和性别的结直肠癌筛查：成本效益分析
影响因子：
12.6
作者：
M. Wong;V. Chan;Jeffrey P. Shum;J. Ching;S. Ng;Thomas Y T Lam;A. K. Luk;S. Wong;S. Ng;Justin C.Y. Wu;F. Chan;J. Sung
通讯作者：
J. Sung