Research on Economical Evaluation of Genetic Testing Diagnosis of Familial Cancer

目的和方法：家族性腺瘤性息肉病(FAP)的成本效益比等与传统的标准治疗相比是大的，当假设：对家族性肿瘤阳性的人进行癌症因素基因检测，并进行化学预防和预防性切除时，成本效果分析和成本效用分析的结果同样优秀。-通过系统分析进行验证。调查模型和调查结果。两年的执行项目如下：(1)在征得1名FAP患者和1名家属同意的基础上，开展了FACT-G不安措施(STAI)、FAP癌基因检查等生活质量调查民意调查。以一例多发性结肠腺瘤患者为研究对象，进行了同样的调查，并进行了对比对比。(2)针对基因检测带来的心理影响，实施了基因检测…建立了主要癌症体检进展的系统模型--基于基因医疗累计医疗费用与劳动生产率的资产负债表，确定了经济尝试诊断模型。(4)对家族性肿瘤的化学预防进行了经济评价。结果：虽然生活质量各项目和衡量指标存在变化，并对自觉健康者进行遗传筛查前约(1)和(2)个月作为遗传筛查的结果，作为FAP患者(N=80例)和多发性自然结肠腺瘤患者(N=18例)在检查结果指征前、后无明显变化。(4)根据乳酸菌学生菌片处方可控制中级以上大肠肿瘤发生的数据，对目前为止的各项防癌效果参数进行了设置和经济评价。4年后，处方组的人均累积费用为72342日元，衣着组为52596日元。考虑：乳酸菌片方组的药费虽然比未服用组的药费高，但如果从现在开始长期存活的概率等差异变得明显，成本-效果分析的结果可能会产生差异。较少

The purpose and methods : The familial adenomatous polyposis (FAP) of a cost benefit ratio etc. is large as compared with the conventional standard medical treatment, when "hypothetical : cancer factor genetic testing is performed and chemistry prevention and a preclusive excision way are carried out to a positive person about a familial tumor. the result of cost-effectiveness analysis and cost utility analysis is excellent similarly."-it verifies by analysis of a system. model and results of an investigation. The enforcement item for two years is as follows(1)Based on the consent of a FAP patient and a family, the opinion poll of QOL investigations, such as FACT-G an uneasy measure (STAI), and FAP oncogene inspection was carried out. As an object case, about the patient of a frequent occurrence nature colonic adenoma, same investigation was conducted and comparison contrast was carried out.(2)About the mental impact which genetic testing brings about, implementation of genetic testing … More and the indication of a result considered the influence which it has on a patient's QOL.(3)System model of medical-examination progress of main cancers is developed -based on the balance sheet of the accumulation medical expenses of gene medical treatment, and labor productivity, the model for trying diagnosis of the economy was fixed.(4)Economical evaluation of chemistry Prevention of a familial tumor was tried.Result : Although the existence of change of the degree of QOL each item and an uneasy measure, and self-conscious healthy was examined genetic-screening before about (1) and (2) in one month after an indication as a result of genetic screening, a change as significant before and behind an inspection result indication as a FAP patient (N=80) and a frequent occurrence nature colonic-adenoma patient (N=18) was not shown. (4)Based on the data that generating of the large intestine tumor more than the degree of middle class can be controlled by lactic-acid-bacterium student bacillus tablet recipe expected, a setup and economical evaluation were tried for various parameters until now about the cancer preventive effect. The per capita accumulation expense of a four years after was the recipe group of 72342 yen, and the group for clothing of 52596 yen.Consideration : Although a lactic-acid-bacterium tablet recipe group exceeds the expense of a non-taking group by a drug cost, if the difference of the probability of survival long-term from now on etc. becomes clear, a difference may produce it in the result of cost-effectiveness analysis. Less