| 马 兰,任文辉,赵艳霞.2015年农村妇女基于超声优化流程的乳腺癌筛查项目卫生经济学初步评价[J].中国肿瘤,2019,28(12):891-895. |
| 2015年农村妇女基于超声优化流程的乳腺癌筛查项目卫生经济学初步评价 |
| Cost-Effectiveness of Optimized Ultrasound-Based Breast Cancer Screening for Chinese Rural Women in 2015 |
| 中文关键词 修订日期：2019-08-05 |
| DOI：10.11735/j.issn.1004-0242.2019.12.A002 |
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| 中文关键词: 乳腺癌筛查 超声筛查 成本效果 早期发现成本系数 中国农村 |
| 英文关键词:breast cancer screening ultrasound screening cost-effectiveness early detection cost index Chinese rural area |
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| 中文摘要: |
| 摘 要：［目的］初步分析2015年我国农村妇女基于超声优化流程的乳腺癌筛查数据的成本效果。［方法］ 利用2015年国家妇幼重大公共卫生服务项目信息直报系统中全国30个省（区、市）706个县上报的乳腺癌筛查项目季度统计表和阳性个案报表，计算乳腺癌检出率、早诊率和早期发现成本系数等指标，并对不同筛查模式、不同年龄组，以及不同地区筛查项目的成本效果进行比较分析。［结果］ 2015年我国农村妇女基于超声优化流程的乳腺癌筛查项目中，乳腺癌检出率为0.85‰，早期癌检出率为0.73‰，早诊率为85.25%。总筛查成本11 954.00万元，检出1例乳腺癌成本9.33万元，检出1例早期乳腺癌成本10.95万元，全国总体早期发现成本系数为2.19；基于超声检查的乳腺癌筛查模式的早期发现成本系数(2.19)与仅超声初筛(2.13)几乎一致；35~39岁年龄组的早期发现成本系数为3.97，40~64岁年龄组介于1.87~2.66；不同地区的早期发现成本系数为东部(1.65)、中部(2.12)低于西部(3.21)(χ2=15.8835，P<0.0001；χ2=26.6755，P<0.0001）。［结论］ 我国农村妇女基于超声优化流程的乳腺癌筛查项目具有较好成本效果，其中40岁以上年龄组成本效果更好，东部和中部地区的成本效果优于西部地区。 |
| 英文摘要: |
| Abstract：［Purpose］ To assess the cost-effectiveness of optimized ultrasound-based breast cancer screening program for Chinese rural women in 2015. ［Methods］ The breast cancer screening data were collected from the online report system of national key woman and child public health service programs in 706 counties of 30 provinces in 2015. The detection rates of breast cancer and early breast cancer，as well as the early detection cost index（EDCI） were calculated. The cost-effectiveness were compared among different screening strategies，age groups and geographic areas.［Results］ The detection rates of breast cancer and early breast cancer were 0.85/1000 and 0.73/1000，respectively. The early diagnosis rate was 85.25%，and the overall EDCI was 2.19. The EDCI of optimized ultrasound-based breast cancer screening(2.19) was close to that of only ultrasound screening(2.13). The EDCI of age group 35~39 was 3.97，and those of age groups >40 were 1.87~2.66. The EDCIs of eastern areas(1.65) and central areas(2.12) were lower than that of western areas(3.21)(χ2=15.8835，P<0.0001；χ2=26.6755，P<0.0001）.［Conclusion］ The optimized ultrasound-based breast cancer screening program for Chinese rural women has a good cost-effectiveness，and the cost-effectiveness for women aged over 40 years is better. The cost-effectiveness of screening in eastern and central areas is superior to that of the western areas. |
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