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评估在美国国家乳腺癌和宫颈癌早期检测计划中增加对低收入妇女宫颈癌筛查的影响。

Estimating the impact of increasing cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program among low-income women in the USA.

机构信息

Division of Public Health Sciences, Department of Surgery, School of Medicine, Washington University in St. Louis, 660 S. Euclid Avenue, Campus, Box 8100, St. Louis, MO, 63110, USA.

Division of Cancer Prevention and Control, CDC, Atlanta, GA, 30341, USA.

出版信息

Cancer Causes Control. 2020 Jul;31(7):691-702. doi: 10.1007/s10552-020-01314-z. Epub 2020 May 20.

Abstract

PURPOSE

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides free cervical cancer screening to low-income women. This study estimated the health benefits gained in terms of life years (LYs) saved and quality-adjusted life years (QALYs) gained if cervical cancer screening by the NBCCEDP increased to reach more eligible women.

METHODS

Data from Surveillance, Epidemiology, and End Results, NBCCEDP, and Medical Expenditure Panel Surveys were used. LYs saved and QALYs gained/100,000 women were estimated using modeling methods. They were used to predict additional health benefits gained if screening by the NBCCEDP increased from 6.5% up to 10-25% of the eligible women.

RESULTS

Overall, per 100,000 women screened by the NBCCEDP, 1,731 LYs were saved and 1,608 QALYs were gained. For white women, 1,926 LYs were saved and 1,780 QALYs were gained/100,000 women screened by the NBCCEDP. For black women, 1,506 LYs were saved and 1,300 QALYs were gained/100,000 women screened. If the proportion of eligible women screened by the NBCCEDP increased to 10-25%, the estimated health benefits would range from 6,626-34,896 LYs saved and 6,153-32,407 QALYs gained.

CONCLUSIONS

The reported estimates emphasize the value of cervical cancer screening program by extending LE in low-income women. Further, it demonstrates that screening a higher percentage of eligible women in the NBCCEDP may yield more health benefits.

摘要

目的

国家乳腺癌和宫颈癌早期检测计划(NBCCEDP)为低收入妇女提供免费的宫颈癌筛查。本研究旨在估算如果 NBCCEDP 增加宫颈癌筛查的比例,使更多符合条件的妇女受益,那么在挽救生命年(LYs)和获得质量调整生命年(QALYs)方面所获得的健康收益。

方法

使用监测、流行病学和最终结果(SEER)、NBCCEDP 和医疗支出面板调查的数据。采用建模方法估计每 10 万妇女因筛查而节省的 LYs 和获得的 QALYs,并用于预测如果 NBCCEDP 的筛查比例从 6.5%增加到 10-25%,将会获得多少额外的健康收益。

结果

总体而言,每 10 万名接受 NBCCEDP 筛查的妇女,可节省 1731 个 LYs,获得 1608 个 QALYs。对于白人妇女,每 10 万妇女可节省 1926 个 LYs,获得 1780 个 QALYs。对于黑人妇女,每 10 万妇女可节省 1506 个 LYs,获得 1300 个 QALYs。如果接受 NBCCEDP 筛查的符合条件的妇女比例增加到 10-25%,则预计健康收益将在 6626-34896 LYs 之间,6153-32407 QALYs 之间。

结论

本报告的估计强调了宫颈癌筛查计划的价值,它延长了低收入妇女的预期寿命。此外,它表明,NBCCEDP 中筛查更高比例的符合条件的妇女可能会带来更多的健康收益。

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