Lineberger Comprehensive Cancer Center, Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, NC, USA.
Med J Aust. 2011 Feb 21;194(4):180-5. doi: 10.5694/j.1326-5377.2011.tb03766.x.
To examine the costs and cost-effectiveness of full implementation of biennial bowel cancer screening for Australian residents aged 50-74 years.
Identification of existing economic models from 1993 to 2010 through searches of PubMed and economic analysis databases, and by seeking expert advice; and additional modelling to determine the costs and cost-effectiveness of full implementation of biennial faecal occult blood test screening for the five million adults in Australia aged 50-74 years.
Estimated number of deaths from bowel cancer prevented, costs, and cost-effectiveness (cost per life-year gained [LYG]) of biennial bowel cancer screening.
We identified six relevant economic analyses, all of which found colorectal cancer (CRC) screening to be very cost-effective, with costs per LYG under $55,000 per year in 2010 Australian dollars. Based on our additional modelling, we conservatively estimate that full implementation of biennial screening for people aged 50-74 years would have gross costs of $150 million, reduce CRC mortality by 15%-25%, prevent 300-500 deaths from bowel cancer, and save 3600-6000 life-years annually, for an undiscounted cost per LYG of $25,000-$41,667, compared with no screening, and not taking cost savings as a result of treatment into consideration. The additional expenditure required, after accounting for reductions in CRC incidence, savings in CRC treatment costs, and existing ad-hoc colonoscopy use, is likely to be less than $50 million annually.
Full implementation of biennial faecal occult blood test screening in Australia can reduce bowel cancer mortality, and is an efficient use of health resources that would require modest additional government investment.
研究澳大利亚 50-74 岁居民实施两年一次肠癌筛查的成本和成本效益。
通过检索 PubMed 和经济分析数据库以及征求专家意见，从 1993 年至 2010 年确定了现有的经济模型；并进行额外建模，以确定在澳大利亚 50-74 岁的 500 万成年人中全面实施每两年一次粪便潜血试验筛查的成本和成本效益。
预防肠癌死亡人数、成本以及两年一次肠癌筛查的成本效益（每增加一个生命年的成本[LYG]）。
我们确定了六项相关的经济分析，这些分析都发现结直肠癌（CRC）筛查非常具有成本效益，2010 年澳大利亚元的每年每 LYG 成本低于 55000 美元。根据我们的额外建模，我们保守估计，对 50-74 岁人群实施全面的两年一次筛查，总成本将达到 1.5 亿美元，可降低 CRC 死亡率 15%-25%，预防 300-500 例肠癌死亡，并每年节省 3600-6000 个生命年，未贴现的每 LYG 成本为 25000-41667 美元，与不筛查相比，且不考虑因治疗而节省的成本。在考虑到 CRC 发病率下降、CRC 治疗成本节省以及现有的临时结肠镜检查使用情况后，所需的额外支出每年可能不到 5000 万美元。
在澳大利亚全面实施两年一次粪便潜血试验筛查可以降低肠癌死亡率，并且是对卫生资源的有效利用，只需要政府适度增加投资。
