结直肠癌筛查的成本效益：来自诺丁汉粪便潜血试验的证据。
Cost-effectiveness of screening for colorectal cancer: evidence from the Nottingham faecal occult blood trial.
作者信息
Whynes David K
机构信息
Nottingham FOB Screening Trial, School of Economics, University of Nottingham, Nottingham NG7 2RD, UK.
出版信息
J Med Screen. 2004;11(1):11-5. doi: 10.1177/096914130301100104.
OBJECTIVES
To estimate the cost-effectiveness of faecal occult blood (FOB) screening for colorectal cancer within the Nottingham trial.
SETTING
A randomised controlled trial (1981-present) of 153,000 subjects, of whom approximately half were offered biennial FOB testing over up to five screening rounds.
METHODS
The additional costs of participation in screening relative to symptomatic presentation were calculated by combining the results of (i) a comprehensive audit of resource use on the part of subjects within the trial, (ii) previously-established unit costs for each of the procedures involved. Life expectancy gains were estimated from a survival analysis of those trial subjects who had been diagnosed with cancer (screening participants vs controls).
RESULTS
The cost of screening under the Nottingham trial protocol was pound 5290 per cancer detected (at 2002 prices). Under conservative assumptions, the incremental cost per life year gained as a result of screening was pound 1584 (Confidence Interval [CI]:717 to 8612).
目的
在诺丁汉试验中评估粪便潜血（FOB）筛查结直肠癌的成本效益。
背景
一项针对153,000名受试者的随机对照试验（1981年至今），其中约一半受试者在多达五轮筛查中每两年接受一次FOB检测。
方法
通过结合以下结果计算参与筛查相对于症状出现的额外成本：（i）对试验中受试者资源使用情况的全面审计，（ii）之前确定的每个相关程序的单位成本。通过对那些被诊断患有癌症的试验受试者（筛查参与者与对照组）进行生存分析来估计预期寿命的增加。
结果
按照诺丁汉试验方案，每检测出一例癌症的筛查成本为5290英镑（按2002年价格）。在保守假设下，筛查导致每获得一个生命年的增量成本为1584英镑（置信区间[CI]：717至8612）。
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