Evaluation of new technologies for cancer control based on population trends in disease incidence and mortality.
Evaluation of new technologies for cancer control based on population trends in disease incidence and mortality.
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根据人口疾病发病率和死亡率趋势评估癌症控制新技术。
DOI：
10.1093/jncimonographs/lgt010
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Lansdorp-Vogelaar,Iris
中科院分区：
文献类型：
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作者：
Etzioni,Ruth;Durand-Zaleski,Isabelle;Lansdorp-Vogelaar,Iris
癌症干预措施往往在其有效性证据出现之前就在人群中传播。人口疾病趋势为评估疾病的特点和干预措施的潜在影响提供了一个自然的实验。我们回顾了从人口数据中提取信息的模型，用于癌症筛查干预措施的经济评估。我们特别关注前列腺癌的前列腺特异性抗原（PSA）筛查，并描述了可用于预测竞争性筛查政策的可能成本和收益的方法。结果表明，活组织检查可检出前列腺癌的终生概率为33%，未经筛查而临床诊断的机会为13%，从发病到临床诊断的平均时间为14年。不太积极的筛查政策，筛查频率较低，使用更保守的标准（例如，较高的PSA阈值）进行活检转诊可能会大大降低PSA筛查成本，对获益的影响不大。
Cancer interventions often disseminate in the population before evidence of their effectiveness is available. Population disease trends provide a natural experiment for assessing the characteristics of the disease and the potential impact of the intervention. We review models for extracting information from population data for use in economic evaluations of cancer screening interventions. We focus particularly on prostate-specific antigen (PSA) screening for prostate cancer and describe approaches that can be used to project the likely costs and benefits of competing screening policies. Results indicate that the lifetime probability of biopsy-detectable prostate cancer is 33%, the chance of clinical diagnosis without screening is 13%, and the average time from onset to clinical diagnosis is 14 years. Less aggressive screening policies that screen less often and use more conservative criteria (e.g., higher PSA thresholds) for biopsy referral may dramatically reduce PSA screening costs with modest impact on benefit.