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盐城市淮河流域地区居民上消化道癌早诊早治项目筛查效果评价

Evaluation of the screening effect of the Early Diagnosis and Treatment Project for Upper Gastrointestinal Cancer among Residents in the Huai River Basin Area of Yancheng City

投稿时间：2026-05-11 修订日期：2026-07-02

DOI：

中文关键词: 上消化道肿瘤、发病密度、相对风险、成本效果

英文关键词:upper gastrointestinal cancer incidence density relative risk cost-effectiveness

基金项目:江苏省疾病预防控制局科技计划项目（JSJK2026D00038）;盐城市卫健委医学科研立项项目（YK2025153）

作者	单位	邮编
吴玲玲	盐城市疾病预防控制中心	224100
田庆	盐城市疾病预防控制中心	224100
刘付东^*	盐城市疾病预防控制中心	224100
何飞	盐都区疾病预防控制中心	224100
陈万庚	盐都区疾病预防控制中心	224100

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中文摘要:

摘要：[目的] 掌握盐都区淮河流域上消化道癌早诊早治项目筛查项目效果，评估项目对盐都区恶性肿瘤发病和死亡风险的影响。[方法] 采用整群抽样的方法，收集2013-2017年盐都区参加淮河流域上消化道癌早诊早治项目数据和2013-2020年盐都区肿瘤登记系统中肿瘤的发病和死亡数据。将参与筛查人群作为筛查组，未能参与项目的人群作为未筛查组，采用相对危险度评估筛查项目对盐都区发病和死亡风险的影响，成本效果分析筛查项目的经济学效益。[结果] 2013-2017年共47717人纳入队列，其中筛查组13335人，未筛查组34382人。食管癌的发病风险较非筛查组高72%（RR=1.72，95%CI=1.49~1.99，P＜0.05），胃癌的发病风险高73%（RR=1.73，95%CI=1.43~2.08，P＜0.05），筛查组的全部恶性肿瘤的发病风险较未筛查组高29%（RR=1.29，95%CI=1.19~1.41，P＜0.05）。筛查组的食管癌死亡风险较非筛查组高28%（RR=1.28，95%CI=0.89~1.79，P=0.16），但是差异没有统计学意义，胃癌死亡风险高48%（RR=1.48，95%CI=1.06~2.02，P＜0.05），筛查组的全部恶性肿瘤的死亡风险较未筛查组高28%（RR=1.28，95%CI=1.12~1.46，P＜0.05）。成本效果分析结果显示，项目的成果效果比为5.56万元，发现早期病例的平均费用为8.70万元，早期发现成本系数为1.25。[结论] 盐都区淮河流域上消化道早诊早治项目具有良好的成本效用价值，筛查组恶性肿瘤的发病密度、死亡密度、发病风险和死亡风险均高于未筛查组，提示筛查工作可能发现更多的患者，有助于上消化道癌的早期发现，从而降低人群的发病率和死亡率。

英文摘要:

Abstract:[Objective]?To evaluate the effect of the Huai River Basin Upper Gastrointestinal Cancer Early Diagnosis and Treatment Project in Yandu District, and to assess its impact on the incidence and mortality of malignant tumors in Yandu District. [Methods]?Using cluster sampling, data were collected from participants of the Huai River Basin Upper Gastrointestinal Cancer Early Diagnosis and Treatment Project in Yandu District from 2013 to 2017, as well as cancer incidence and mortality data from the Yandu District Cancer Registry from 2013 to 2020. The screened population was defined as the screening group, and those who did not participate in the project were defined as the unscreened group. Relative risk was used to evaluate the impact of the screening project on the risk of incidence and mortality in Yandu District. Cost-effectiveness analysis was used to evaluate the economic benefits of the screening project. [Results]?A total of 47,717 individuals were included in the cohort from 2013 to 2017, including 13,335 in the screening group and 34,382 in the unscreened group. Compared with the unscreened group, the screening group had a 72% higher risk of esophageal cancer (RR=1.72, 95%CI=1.49–1.99, P<0.05), a 73% higher risk of gastric cancer (RR=1.73, 95%CI=1.43–2.08, P<0.05), and a 29% higher risk of all malignancies (RR=1.29, 95%CI=1.19–1.41, P<0.05). The screening group had a 28% higher risk of esophageal cancer mortality (RR=1.28, 95%CI=0.89–1.79, P=0.16), which was not statistically significant, a 48% higher risk of gastric cancer mortality (RR=1.48, 95%CI=1.06–2.02, P<0.05), and a 28% higher risk of all-cause malignancy mortality (RR=1.28, 95%CI=1.12–1.46, P<0.05) compared with the unscreened group. Cost-effectiveness analysis showed that the cost-effectiveness ratio of the project was 55,600 yuan, the average cost per early case detected was 87,000 yuan, and the early detection cost coefficient was 1.25. [Conclusion]?The Yandu District Huai River Basin Upper Gastrointestinal Cancer Early Diagnosis and Treatment Project has good cost-effectiveness. The incidence density, mortality density, and relative risks of incidence and mortality for malignant tumors were higher in the screening group than in the unscreened group, suggesting that screening may help detect more patients and facilitate early detection of upper gastrointestinal cancer, thereby reducing the population-based incidence and mortality.

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