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谁希望通过正电子发射断层显像(PET)进行癌症筛查?日本的一项条件价值评估调查。

Who wants cancer screening with PET? A contingent valuation survey in Japan.

作者信息

Yasunaga Hideo

机构信息

Department of Health Management & Policy, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 1138655, Japan.

出版信息

Eur J Radiol. 2009 Apr;70(1):190-4. doi: 10.1016/j.ejrad.2007.11.020. Epub 2008 Feb 21.

Abstract

OBJECTIVES

Cancer screening using whole-body fluorodeoxyglucose-positron emission tomography (FDG-PET) has gradually become popular in Japan. Although some studies have reported high cancer detection rates with PET screening, the justification for such an approach is still unclear, and no evidence has been provided to indicate that PET screening reduces cancer mortality. We measured the general public's willingness to pay (WTP) for this service using a contingent valuation method, after providing them with sufficient information regarding the efficacy and limitations of the service.

METHODS

A computer-assisted questionnaire survey was conducted on males and females in Japan aged between 40 and 59 years. The study participants (n=390) were provided with sufficient information about the PET procedure, the high cancer detection rate, false-negatives/false-positives and the fact that the mortality-reducing effect of PET screening has not yet been demonstrated. The participants' WTP was ascertained by a double-bound dichotomous choice approach.

RESULTS

The average WTP among all the participants was $68.0 (95% confidence interval: $56.9-79.2). A Weibull regression analysis showed that income, degree of concern about health, and family history of cancer were significant factors affecting WTP.

CONCLUSIONS

The actual charge for PET screening in Japan is approximately $1000 on average, which is significantly higher than the participants' WTP for the actual benefit obtained from the service. If the Japanese healthcare consumers are well-informed, most of them would avoid purchasing such a costly service.

摘要

目的

在日本,使用全身氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)进行癌症筛查已逐渐流行。尽管一些研究报告称PET筛查的癌症检出率很高,但这种方法的合理性仍不明确,也没有证据表明PET筛查能降低癌症死亡率。在向公众提供有关该服务的功效和局限性的充分信息后,我们使用条件价值评估法测量了公众对这项服务的支付意愿(WTP)。

方法

对日本40至59岁的男性和女性进行了计算机辅助问卷调查。研究参与者(n = 390)获得了关于PET检查程序、高癌症检出率、假阴性/假阳性以及PET筛查的死亡率降低效果尚未得到证实等充分信息。参与者的WTP通过双边界二分选择法确定。

结果

所有参与者的平均WTP为68.0美元(95%置信区间:56.9 - 79.2美元)。威布尔回归分析表明,收入、对健康的关注程度和癌症家族史是影响WTP的重要因素。

结论

日本PET筛查的实际费用平均约为1000美元,这明显高于参与者为从该服务中获得的实际益处所支付的意愿。如果日本医疗保健消费者了解充分信息,他们中的大多数人会避免购买如此昂贵的服务。

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