Espinola Natalia, Maceira Daniel, Palacios Alfredo
Acta Gastroenterol Latinoam. 2016 Mar;46(1):8-17.
International evidence show that screening for colorectal cancer is cost-effective; however, in Argentina is unknown.
The study shows the results of a cost-effectiveness evaluation based on two alternative mechanisms: annual faecal immunochemical testing (FIT), and colonoscopy every ten years in Argentina.
The study develops a Mar- kov model in ten stages, based on information provided by the INC, prior literature review and on-line questionnaires to physicians enrolled in the four major scientific societies related to cancer. Cost information arrived from the Na- tional Superintendence of Social Health Insurances and a sample of managers in social and private insurance schemes.
The most cost-effective strategy consisted annual FIT, in comparison no intervention and colonoscopy every 10 years. The incremental cost effectiveness ratio (ICER) of FIT versus no intervention was of 980.5 pesos per QALY The findings were robust to deterministic sensitivity analysis.
We confirmed that screening for CRC is a cost-effective intervention. Whereas the CCR is one of the leading causes of mortality in Argentina, these results support the widespread use of screening for CRC using anual FIT which proves to be highly cost effective for the country.
国际证据表明,结直肠癌筛查具有成本效益;然而,在阿根廷情况未知。
本研究展示了基于两种替代机制的成本效益评估结果:每年进行粪便免疫化学检测(FIT),以及在阿根廷每十年进行一次结肠镜检查。
该研究基于国家癌症研究所提供的信息、先前的文献综述以及对四大癌症相关科学学会注册医生的在线问卷调查,开发了一个十阶段的马尔可夫模型。成本信息来自国家社会医疗保险监管机构以及社会和私人保险计划的管理人员样本。
与不进行干预和每10年进行一次结肠镜检查相比,最具成本效益的策略是每年进行FIT。FIT与不干预相比的增量成本效益比(ICER)为每质量调整生命年980.5比索。研究结果对确定性敏感性分析具有稳健性。
我们证实,结直肠癌筛查是一种具有成本效益的干预措施。鉴于结直肠癌是阿根廷主要死因之一,这些结果支持广泛使用每年进行FIT的结直肠癌筛查,这被证明对该国具有很高的成本效益。