Department of Public Health, Erasmus MC, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Best Pract Res Clin Gastroenterol. 2010 Aug;24(4):439-49. doi: 10.1016/j.bpg.2010.04.004.
There are several modalities available for a colorectal cancer (CRC) screening program. When determining which CRC screening program to implement, the costs of such programs should be considered in comparison to the health benefits they are expected to provide. Cost-effectiveness analysis provides a tool to do this. In this paper we review the evidence on the cost-effectiveness of CRC screening. Published studies universally indicate that when compared with no CRC screening, all screening modalities provide additional years of life at a cost that is deemed acceptable by most industrialized nations. Many recent studies even find CRC screening to be cost-saving. However, when the alternative CRC screening strategies are compared against each other in an incremental cost-effectiveness analysis, no single optimal strategy emerges across the studies. There is consensus that the new technologies of stool DNA testing, computed tomographic colonography and capsule endoscopy are not yet cost-effective compared with the established CRC screening tests.
有几种方法可用于结直肠癌（CRC）筛查计划。在确定要实施哪种 CRC 筛查计划时，应考虑这些计划的成本与其预期提供的健康益处。成本效益分析为此提供了一种工具。在本文中，我们回顾了 CRC 筛查的成本效益证据。已发表的研究普遍表明，与不进行 CRC 筛查相比，所有筛查方法都能提供额外的寿命，而成本被大多数工业化国家认为是可以接受的。许多最近的研究甚至发现 CRC 筛查具有成本效益。然而，当在增量成本效益分析中对替代 CRC 筛查策略进行相互比较时，没有一种单一的最佳策略在所有研究中出现。人们普遍认为，与已确立的 CRC 筛查测试相比，粪便 DNA 检测、计算机断层结肠成像和胶囊内镜等新技术还不具有成本效益。
