| 阮奠虎,崔王飞,王新正,等.2018年山西省阳城县上消化道癌内镜筛查结果及成本效果分析[J].中国肿瘤,2025,34(3):209-214. |
| 2018年山西省阳城县上消化道癌内镜筛查结果及成本效果分析 |
| Cost-Effectiveness Analysis of Endoscopic Screening of Upper Gastrointestinal Cancer in Yangcheng County， Shanxi Province in 2018 |
| 投稿时间：2024-06-17 |
| DOI：10.11735/j.issn.1004-0242.2025.03.A007 |
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| 中文关键词: 上消化道癌 内镜筛查 检出率 早诊率 成本效果 山西 |
| 英文关键词:upper gastrointestinal cancer endoscopic screening detection rate early diagnosis rate cost-effectiveness Shanxi |
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| 中文摘要: |
| 摘 要： ［目的］ 分析2018年山西省阳城县上消化道癌早诊早治筛查项目的成本效果。［方法］ 选取2018年阳城县参与上消化道癌筛查的40~69岁人群作为研究对象，对其进行上消化道癌内镜碘染色筛查及指示性活检，计算上消化道癌前病变及阳性病变检出率、早诊率等指标，并比较不同组间率的差异。同时收集筛查成本资料，计算人均筛查成本、发现早期病例平均费用和早期发现成本系数（early detection cost index，EDCI）等指标。［结果］ 2018年阳城县共完成内镜筛查2 950名，2 073名完成病理活组织检查，活检率为70.27%。共检出癌前病变374例（检出率为12.68%）和阳性病例52例（检出率为1.76%），其中，上消化道癌17例，检出率为0.58%；早期病例44例，早诊率为84.62%。男性癌前病变与阳性病例检出率均高于女性，但是上消化道癌早诊率低于女性；50岁及以上上消化道癌前病变与阳性病例检出率及上消化道癌早诊率均高于40~49岁人群。成本效果分析结果显示，筛查检出1例阳性病变的成本为25 528.85元，检出1例早期病例筛查成本为30 170.46元，EDCI为0.52，表明上消化道癌早诊早治极具成本效果价值。［结论］ 阳城县上消化道癌早诊早治筛查项目成效显著，后续筛查工作应重点关注男性人群及50岁以上人群，加强上消化道癌筛查宣传工作。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze the cost-effectiveness of endoscopic screening for upper gastrointestinal cancer in Yangcheng County of Shanxi Province. ［Methods］ People aged from 40 to 69 who participated in upper gastrointestinal cancer screening in Yangcheng County in 2018 were selected as the study subjects to participate in upper gastrointestinal cancer screening in 2018， and endoscopic examination with iodine staining and indicative biopsy were performed for screening. The detection rates of precancerous lesions and upper gastrointestinal malignancies， and early diagnosis rates were calculated， and compared among different groups. The data of screening cost were collected; and the per capita screening cost， the average cost of early case detection and early detection cost index (EDCI) were calculated. ［Results］ Among 2 950 subjects undergoing endoscopy， pathological biopsy was completed in 2 073 cases (70.27%)， 374 cases of precancerous lesions (12.68%) and 52 cases of malignancies (1.76%) were detected， among which 17 cases were upper gastrointestinal cancer with a detection rate of 0.58%， there were 44 early cases with an early diagnosis rate of 84.62%. The detection rate of precancerous lesions and positive cases in men was higher than that of women， but the early diagnosis rate of upper gastrointestinal cancer was lower than that of women; the detection rate of positive cases and digestive tract cancer of 50 years and above were higher than those of people aged 40 to 49. The cost of screening for one positive lesion was 25 528.85 CNY， the cost of screening for one early case was 30 170.46 CNY. The EDCI was 0.52， indicating a good cost-effective value. ［Conclusion］ The study shows that the early diagnosis and early treatment screening program of upper gastrointestinal cancer has achieved remarkable results in Yangcheng County. The follow-up screening work should focus on men and people over 50 years old， and strengthen the publicity of upper gastrointestinal screening for cancer. |
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