| 郭兰伟,郑黎阳,陈 琼,等.2013—2019年河南省城市地区上消化道癌内镜筛查结果及成本效果分析[J].中国肿瘤,2023,32(2):89-97. |
| 2013—2019年河南省城市地区上消化道癌内镜筛查结果及成本效果分析 |
| Results and Cost-effectiveness of Upper Gastrointestinal Cancer Screening Program Among Urban Residents in Henan Province from 2013 to 2019 |
| 投稿时间：2022-08-29 |
| DOI：10.11735/j.issn.1004-0242.2023.02.A002 |
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| 中文关键词: 上消化道癌 筛查 参与率 检出率 成本效果 河南 |
| 英文关键词:upper gastrointestinal cancer screening compliance detection rate cost-effectiveness Henan |
| 基金项目:国家重大公共卫生服务专项——城市癌症早诊早治项目；河南省中青年卫生健康科技创新优秀人才培养项目（YXKC2022045） |
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| 中文摘要: |
| 摘 要：［目的］ 综合评价2013—2019年河南省城市居民上消化道癌筛查的结果和成本效果。［方法］ 基于河南省2013—2019年开展的城市癌症早诊早治项目，分析40~74岁城市居民上消化道癌高危率和内镜筛查参与率，采用χ2检验比较不同组间率的差异。同时分析上消化道癌及其癌前病变检出率，测算以检出1例病变的成本为指标的成本效果比。［结果］ 共进行有效问卷调查282 262人，评估为食管癌或胃癌高危68 651名，高危率为24.32%，其中13 191名接受了内镜检查，内镜筛查参与率为19.21%，共检出上消化道癌31例（检出率为0.24%）和癌前病变386例（检出率为2.93%）。成本效果分析结果显示，筛查检出1例上消化道癌或癌前病变的成本为18 025.46元，其中检出1例上消化道癌的成本达242 471.52元；男性成本效果比小于女性；年龄组越大，成本效果比越小。敏感性分析提示，提高内镜筛查参与率可降低成本效果比。［结论］ 采用问卷调查浓缩高危人群以及内镜检查策略有助于发现上消化道病变和降低筛查成本，但内镜筛查参与率较低，限制了筛查整体效果和经济学收益，应进一步加强高危人群内镜检查的组织动员工作。 |
| 英文摘要: |
| Abstract： ［Purpose］ To analyze the results and cost-effectiveness of upper gastrointestinal cancer(UGC) screening program among urban residents in Henan Province from 2013 to 2019. ［Methods］ The UGC screening program based on the protocol of Cancer Screening Program in Urban China was conducted among the residents aged 40~74 years old in Henan Province from 2013 to 2019. The high-risk rate， compliance rate， the detection rate of UGC and precancerous lesions were analyzed and compared among different groups. The cost-effectiveness ratio(CER) was calculated by using the cost per lesion detected. ［Results］ A total of 282 262 participants completed the risk assessment questionnaire， 68 651(24.32%) were identified as high risk subjects of esophageal cancer or gastric cancer and 13 191(19.21%) of them received the endoscopic examination. The detection rates of UGC and precancerous lesions were 0.24%(31 cases) and 2.93%(386 cases)， respectively. Cost-effectiveness analysis showed that the costs were 18 025.46 Yuan per detected UGC or precancerous lesion and 242 471.52 Yuan per UGC detection. The CER of men was lower than that of women and decreased along with age. Sensitivity analysis showed that CERs were expected to decrease when the compliance rate of endoscopy was increasing. ［Conclusion］ The current screening program is useful in detecting the precancerous upper gastrointestinal tract lesions， but the low endoscopic participation rate limits the overall effect and economic benefits of screening. It is necessary to improve the awareness and acceptance of endoscopic examination among the high-risk UGC population. |
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