Feng X, Hua Z L, Qian D F, Zhou Q, Shi A W, Wei W W, Zhou J Y
Cancer Research Institution, Yangzhong People's Hospital, Yangzhong 212200, China.
School of Health Policy and Management, Nanjing Medical University, Nanjing 211166, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2019 Nov 6;53(11):1115-1118. doi: 10.3760/cma.j.issn.0253-9624.2019.11.008.
To evaluate the effectiveness and benefit of the upper gastrointestinal cancer screening in Yangzhong city, Jiangsu province, from 2009 to 2015. From 2009 to 2015, 31 natural villages with high-incidence of upper gastrointestinal cancer were selected from Baqiao town, Youfang town and Xinglong sub-district in Yangzhong city. 13 776 residents aged 40 to 69 years old were recruited and screened for upper gastrointestinal cancer by using endoscopic examination and pathological diagnosis. Two economic evaluation methods, cost-effectiveness analysis and cost-benefit analysis, were performed to evaluate the current screening schemes. The mean age of all respondents were (53.60±8.14) years old and the males accounted for 43.64% (6 012). A total of 502 cases of upper gastrointestinal tract lesions were detected, including 100 cases of cancer (62 cases of esophagus, gastric/cardiac early stage cancer, 38 cases of advanced stage cancer), 38 cases of severe esophageal hyperplasia/carcinoma in situ, and 15 cases of high-grade intraepithelial neoplasia in stomach/cardia, the detection rate was 0.73%, 0.28% and 0.11%, respectively; the early diagnosis rate was 75.16% (115/153). The cost of a precancerous lesion, a case diagnosed at the early stage and a positive case identified through the upper gastrointestinal cancer screening in Yangzhong City was 10 037.17, 30 460.64 and 22 895.25 RMB, respectively. The early detection cost index from 2009 to 2015 was 0.52, 0.56, 0.48, 0.48, 0.21, 0.30, and 0.26, respectively. The effectiveness-cost ratio from 2009 to 2015 was 3.41, 2.77, 2.66, 2.58, 4.99, 3.12, and 3.48, respectively. The project of early diagnosis and treatment of upper gastrointestinal tract cancer in Yangzhong city has achieved good results and benefits.
为评估2009年至2015年江苏省扬中市上消化道癌筛查的效果和效益。2009年至2015年，从扬中市八桥镇、油坊镇和兴隆街道选取31个上消化道癌高发自然村。招募13776名40至69岁居民，采用内镜检查和病理诊断对上消化道癌进行筛查。采用成本效果分析和成本效益分析两种经济评价方法对现行筛查方案进行评估。所有受访者的平均年龄为（53.60±8.14）岁，男性占43.64%（6012人）。共检测出上消化道病变502例，其中癌症100例（食管、胃/贲门早期癌62例，晚期癌38例），重度食管增生/原位癌38例，胃/贲门高级别上皮内瘤变15例，检出率分别为0.73%、0.28%和0.11%；早期诊断率为75.16%（115/153）。扬中市上消化道癌筛查中癌前病变、早期诊断病例和阳性病例的成本分别为10037.17元、30460.64元和22895.25元。2009年至2015年的早期检测成本指数分别为0.52、0.56、0.48、0.48、0.21、0.30和0.26。2009年至2015年的效果成本比分别为3.41、2.77、2.66、2.58、4.99、3.12和3.48。扬中市上消化道癌早诊早治项目取得了良好的效果和效益。
