EVALUATION OF CERVICAL CANCER SCREENING, ANALYZING COST BENEFIT

宫颈癌筛查评估、成本效益分析

• 批准号: 08672588
• 负责人: OKI Toshiko
• 金额: $ 1.41万
• 依托单位: Saga Medical school
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08672588/
• 关键词: COST BENEFIT; CERVICAL CANCER; MASS SCREENING; MEDICAL EXPENCES; 費用使益; 費用便益分析

The aim of this research is to investigate economic efficiency of cervical cancer screening, comparing cost of mass screening with medical expences.1. Cost of mass screening : This research was done in the area of Saga Central Health Center. The total number of people screened from 1994 to 1996 was 51,458. The number of people who needed closer examinations was 397. Among them cervical cancer was diagnosed in 63 and cervical intraepithelial neoplasia (CJN) was diagnosed in 153. The expenditure of the municipalities for the mass screening during the 3 years adds up to \l66,048,189. If we add cost of close examination to it, the total expenditure is \178,208,189 and cost to diagnose one cancer case is \2,749,336.2. Average medical expenses for each patient who had the screening (49 out of 141 patients stayed in 2 hospitals from 1994 to 1996) was \l, 251,947, and that for 92 patients who didn't have the screening was \2,036,105. Simply the expenses for those who had the screening was \784,158 lower than for those who didn't.3. If mass screening had not been done,(1)Among 153 people who had CIN, 6 would have worsened to invasive cancer, 31 would have worsened to carcinoma in situ.(2) Suppose 100 cases(63 cervical cancer cases plus 37 CIN cases)had not had mass screening, the stages of their disease would have been 39 cases in stage 0, 7 cases in stage Ia, 21 cases in stage Ib, 15 cases in stage II, II cases in stage III and 7 cases in stage IV.(3) Medical expences would have been \162,566,000. Actually, mass screening saved \95,049, O00. But if we add the cost of mass screening to the actual medical expences, the estimated expenses are \78,160,000 smaller.Cervical cancer mass screening can give us early discovery and treatment of the disease, and it also helps us get the treatment at smaller expences. However if we consider the cost of screening it does not reduce social cost.

本研究的目的是探讨宫颈癌筛查的经济效益，比较大规模筛查的成本和医疗费用.大规模筛查的成本：这项研究是在佐贺中央卫生中心地区进行的。1994年至1996年接受检查的总人数为51，458人。需要进一步检查的人数为397人。其中宫颈癌63例，宫颈上皮内瘤样病变（CJN）153例。在这三年中，市政府用于大规模筛查的支出总计为166 048 189日元。如果我们把仔细检查的费用加在一起，总费用是178，208，189日元，诊断一个癌症病例的费用是2，749，336.2日元。每名接受筛查的患者（1994 - 1996年在2家医院住院的141名患者中有49名患者）的平均医疗费用为1，251，947日元，而92名未接受筛查的患者的平均医疗费用为2，036，105日元。简单地说，接受检查的人比不接受检查的人的费用低784，158日元。如果不进行普查，（1）153例CIN患者中，6例发展为浸润癌，31例发展为原位癌; (2)假设100例（宫颈癌63例，CIN 37例）未进行普查，其疾病分期为0期39例，Ia期7例，Ib期21例，II期15例，III期II例，IV期7例。(3)医疗费用为162，566，000日元。实际上，大规模筛查节省了9504.9万日元。但是如果我们把普查的费用加到实际的医疗费用上，估计费用要少78，160，000日元。宫颈癌普查可以让我们早期发现和治疗疾病，也有助于我们以更小的费用获得治疗。然而，如果我们考虑到筛查的成本，它并没有降低社会成本。