Arafa Mostafa Ahmed, Farhat Karim Hamda
Cancer Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Cancer Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Arab J Gastroenterol. 2017 Sep;18(3):136-139. doi: 10.1016/j.ajg.2017.05.011. Epub 2017 Oct 4.
Colorectal cancer (CRC) is the third most common cancer worldwide and the fourth most common cause of death. Reduction in mortality rates in some countries worldwide are most likely ascribed to CRC screening and/or improved treatments. We reviewed the most relevant articles which discuss the cost-effectiveness of colorectal cancer screening procedures, in particular, the recent ones through the last eight years. The effectiveness of screening estimated by discounted life years gained (LYGs) compared to no screening, differed considerably between the studies. Despite these differences, all studies consistently emphasized that screening for CRC was cost-effective compared with no screening for each of the recognized screening strategies. Newer technologies for colorectal cancer screening, including computed tomographic colonography (CTC), faecal DNA test, and Pillcam Colon are less invasive and accurate, however, they are not cost-effective, as their cost was higher than all other established screening strategies. When compliance and adherence to such new techniques are increased more than the established strategies they would be more cost-effective particularly CTC.
结直肠癌(CRC)是全球第三大常见癌症,也是第四大死因。全球一些国家死亡率的降低很可能归因于结直肠癌筛查和/或治疗的改善。我们回顾了最相关的文章,这些文章讨论了结直肠癌筛查程序的成本效益,特别是过去八年的近期文章。与未进行筛查相比,通过获得的贴现生命年(LYGs)估计的筛查有效性在各项研究之间存在很大差异。尽管存在这些差异,但所有研究一致强调,与未对任何公认的筛查策略进行筛查相比,结直肠癌筛查具有成本效益。结直肠癌筛查的新技术,包括计算机断层结肠成像(CTC)、粪便DNA检测和结肠胶囊内镜,侵入性较小且准确性较高,然而,它们不具有成本效益,因为其成本高于所有其他既定的筛查策略。当对这些新技术的依从性和坚持程度超过既定策略时,它们将更具成本效益,尤其是CTC。