广州市社区人群大肠癌筛查项目成本效益分析

目的对广州市首轮大肠癌筛查项目(2015—2017年)进行成本效益分析。方法本研究资料来源于2015—2017年广州市首轮大肠癌筛查结果。总成本包括筛查总成本、腺瘤直接医疗成本及未来肠镜复查和腺瘤复发治疗成本。总效益包括因筛查而早期检出大肠癌所得效益以及因筛查检出腺瘤及癌前病变避免日后发生癌变所得效益。结果 2015—2017年,广州市首轮大肠癌筛查项目花费总成本为3 928.5万元,总效益为12 329.8万元,净效益为8 401.3万元,效益成本比3.1。如果提高肠镜检查顺应性至30%、40%、50%、60%、70%、80%和90%,大肠癌筛查的净效益和效益成本比均逐渐升高。结论广州市首轮大肠癌筛查项目具有成本效益。肠镜检查参与率越高,成本效益越高。

Cost-benefit analysis of colorectal cancer screening program among community population in Guangzhou city

Objective To analyze the cost-benefit of first-round colorectal cancer screening program (CCSP) in Guangzhou city from 2015 to 2017. Methods The data were collected from the first-round CCSP in Guangzhou city from 2015 to 2017. The total cost included the total cost of screening, the cost of direct medical treatment for adenomas, and the cost of future enteroscopy reexamination and treatment for recurrence of adenomas. The total benefit included the benefit of early detection of colorectal cancer and the benefit of avoiding future cancer due to early detection of adenomas and precancerous lesions. Results From 2015 to 2017, the total cost of the first-round CCSP in Guangzhou city was 39.285 million yuan, the total benefit 123.298 million yuan, the net benefit 84.013 million yuan, and the benefit-cost ratio (BCR) 3.1. If colonoscopycompliancewas improved to 30%, 40%, 50%, 60%, 70%, 80% and 90%, the net benefit and BCR of colon cancer screening would gradually increase. Conclusions The first-round CCSP in Guangzhou city is cost-effective. The higher the participation rate of enteroscopy, the higher the cost-benefit.