| 周 琴,梁颖茹,李 燕.广州市人群2015~2017年大肠癌筛查成本分析[J].中国肿瘤,2019,28(4):257-263. |
| 广州市人群2015~2017年大肠癌筛查成本分析 |
| Cost Analysis of Colorectal Cancer Screening Program in Guangzhou，2015~2017 |
| 投稿时间：2018-08-27 |
| DOI：10.11735/j.issn.1004-0242.2019.04.A004 |
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| 中文关键词: 结直肠肿瘤 筛查 成本 广东 |
| 英文关键词:colorectal neoplasms screening cost Guangdong |
| 基金项目:广东省自然科学基金（2016A030313504） |
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| 中文摘要: |
| 摘 要：［目的］ 对广州市首轮大肠癌筛查项目（2015~2017年）进行成本分析。［方法］ 在广州市和12个区项目办进行筛查项目支出信息调查，收集组织管理及筛查直接成本。另选取1243名参与初筛和602名接受肠镜检查的人群分别进行大肠癌筛查非医疗费用调查，收集本轮筛查的间接成本。并分析不同筛查策略下检出成本的差异，并对初筛参与率和肠镜检查参与率进行敏感性分析。 ［结果］ 2015~2017年广州市大肠癌筛查项目成本为3124.7万元，其中直接成本为1422.1万元，占45.5%，间接成本为1702.6万元，占54.5%。本项目癌前病变和癌症单例检出成本分别为27 077元和78 708元。筛查策略不变，如果将初筛参与率和肠镜检查率分别提高到50%和75%，则估算得到单例大肠癌前病变和癌症的检出成本分别降低27.1%、32.0%和 40.9%、53.1%。如果改变筛查策略，1次免疫法粪便隐血检查（以下简称iFOBT）+肠镜检查的筛查策略高危人群、大肠腺瘤和癌前病变的单例检出成本最低； 2次iFOBT+肠镜检查的癌症和早期癌的单例检出成本最低。［结论］ 本轮广州市大肠癌筛查成本较高，按癌前病变和癌症检出数计算，成本最低的是2次iFOBT+肠镜筛查方案；如果提高初筛参与率和肠镜检查参与率，则成本可以明显降低，尤其是提高肠镜检查参与率对降低成本效果明显。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze the costs of colorectal cancer screening program in Guangzhou，2015~2017. ［Methods］ The costs of management and direct cost for colorectal screening program were collected by questionnaire survey from 12 district program offices in Guangzhou；the indirect costs were collected from 1243 participants in prescreening and 602 participants receiving colonoscopy. The difference of detection costs for different screening strategies was analyzed. Sensitivity analysis was used for the participation rate of prescreening and undergoing colonoscopy. ［Results］ The total costs were ￥31.247 million，including ￥14.221 million for direct cost(45.5%) and ￥17.026 million for indirect cost(54.5%)。 The cost for detecting one pre-cancer and cancer patient was ￥27 077 and ￥78 708 respectively. If the participation rates of prescreening and undergoing colonoscopy were increased to 50% and 75%，the detection costs of one pre-cancer and cancer case were decreasing by 27.1%，32.0% and 40.9%，53.1%，respectively. Using the screening strategy of single iFOBT+ followed colonoscopy，the costs for per subjects with high-risk subject，colorectal adenoma or pre-cancer status would be the lowest；using the strategy of two iFOBTs + the followed colonoscopy，the costs for finding one cancer patient would be the lowest. ［Conclusion］ The costs of colorectal cancer screening program in Guangzhou are relatively high. To change the screening strategies or to increase the participation rates of pre-screening and colonoscopy would reduce the costs for positive findings. |
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