基于映射下效用值测量的我国大肠癌筛查策略的成本效用分析

大肠癌已经成为威胁我国居民健康的主要癌症之一。尽管已有的经济学评价研究表明对人群进行筛查是一种具有经济性的预防大肠癌的干预措施，但是，大肠癌的筛查策略呈现多样性，不同国家和地区的经济学评价结果也缺乏借鉴性。因此有必要对我国的大肠癌筛查策略进行经济学评价研究。本研究针对中国学者独创的“优化的无症状大肠癌筛查策略”以国际组织推荐的筛查策略，基于我国国情，首次采用成本效用分析的方法对其进行系统评价。进行成本效用分析时，应用欧洲五维健康量表和大肠癌功能评价系统量表对筛查中不同健康状态人群进行针对性的生命质量评估，并且创新性的将映射法应用于效用值的测量，利用我国权威数据构建高效度的马尔科夫模型，从经济学角度对其进行实证研究。本研究不仅可以为效用值的测量提供一种新途径，探索和解决健康效用值测量面临的技术难题，还有利于优化成本效用分析这一经济学评价技术，能够为我国大肠癌筛查策略的选择提供科学的决策依据。

With its high incidence and mortality, colorectal cancer (CRC) has a serious effect on the health of Chinese population. Previous studies showed that CRC screening was a cost-effective measure for the prevention of CRC. CRC screening strategies presents diversity and it is uncertain which is suitable for Chinese residents. Cost-utility analysis is one of the most popular economics evaluation methods, and is called the gold standard which can provide decision-making basis for the choice of CRC screening.Cost-utility analysis is applied in this study. We developed a Markov model to simulate the progression of two CRC screening and full cost estimated from a social perspective. The suitable CRC strategy resulted from economic evaluation can provide basis for the allocation of health resources, reduce the incidence, mortality and burden of disease of CRC, and to provide a basis for other underdeveloped countries and regions for CRC screening.