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韩国国家宫颈癌筛查项目的成本效益

Cost-effectiveness of Korea's National Cervical Cancer Screening Program.

作者信息

Cho Eun, Kang Moon Hae, Choi Kui Son, Suh Mina, Jun Jae Kwan, Park Eun-Cheol

机构信息

College of Pharmacy, Sookmyung Women's University, Seoul, Korea.

出版信息

Asian Pac J Cancer Prev. 2013;14(7):4329-34. doi: 10.7314/apjcp.2013.14.7.4329.

Abstract

BACKGROUND

Cervical cancer, which is common in developing countries, is also a major health issue in Korea. Our aim was to evaluate the cost-effectiveness of Korea's National Cancer Screening Program (NCSP), implemented in 1999.

MATERIALS AND METHODS

The target population was Korean women 30 years or over who were invited to take part in the NCSP in 2002-2007. By merging NCSP records with Korean Central Cancer Registry data, patients diagnosed with cervical cancer who had been screened were assigned to a "screened group, " while patients diagnosed elsewhere were assigned to a "non-screened group. " Clinical outcomes were measured in terms of life-years saved (LYS), derived from 5-year mortality rates supplied by the Korean National Health Insurance Corporation and National Statistical Office. Direct and travel costs associated with screening were evaluated from the perspective of the payer, the NCSP.

RESULTS

A diagnosis via screening was associated with 2.30 LYS, and the incremental cost-effectiveness ratio (ICER) estimate for screening was 7,581,679 KW/LYS (6,727 USD/LYS). ICER estimates were lower for older patients (≥ 50 years) than younger patients (4,047,033 KW/ LYS vs 5,680,793 KW/LYS). The proportion of early-stage cancers detected was 16.3% higher in the screened group.

CONCLUSIONS

In light of Korea's per capita gross domestic product (32,272 USD in 2012), the current NCSP's incremental cost per LYS appears acceptable.

摘要

背景

宫颈癌在发展中国家较为常见,在韩国也是一个重大的健康问题。我们的目的是评估1999年实施的韩国国家癌症筛查计划(NCSP)的成本效益。

材料与方法

目标人群为2002 - 2007年被邀请参加NCSP的30岁及以上韩国女性。通过将NCSP记录与韩国中央癌症登记数据合并,已接受筛查且被诊断为宫颈癌的患者被分配到“筛查组”,而在其他地方被诊断的患者被分配到“未筛查组”。临床结局以挽救的生命年数(LYS)衡量,数据来自韩国国民健康保险公团和国家统计局提供的5年死亡率。从支付方NCSP的角度评估与筛查相关的直接成本和交通成本。

结果

通过筛查诊断与2.30个LYS相关,筛查的增量成本效益比(ICER)估计为7,581,679韩元/LYS(6,727美元/LYS)。老年患者(≥50岁)的ICER估计低于年轻患者(4,047,033韩元/LYS对5,680,793韩元/LYS)。筛查组中早期癌症的检出比例高16.3%。

结论

鉴于韩国的人均国内生产总值(2012年为32,272美元),当前NCSP每LYS的增量成本似乎是可接受的。

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