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评估罗马尼亚西部宫颈癌筛查与治疗的成本效益

Evaluating the Cost-Effectiveness of Cervical Cancer Screening and Treatment in Western Romania.

作者信息

Petre Ion, Negru Șerban Mircea, Buleu Florina, Moleriu Radu Dumitru, Mercioni Marina Adriana, Petre Izabella, Bordianu Anca, Turi Vladiana, Marc Luciana, Popa Daian Ionel, Vlad Daliborca Cristina

机构信息

Doctoral School, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.

Department of Functional Sciences, Medical Informatics and Biostatistics Discipline, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.

出版信息

Curr Oncol. 2025 Jun 7;32(6):336. doi: 10.3390/curroncol32060336.

Abstract

As a leading European country in terms of cervical cancer incidence and mortality, there has been a pressing need for Romania to upgrade its cervical cancer management. The criteria set by the International Federation of Gynecology and Obstetrics indicate that different treatments should have a similar trend concerning progression-free survival and overall survival at all the various stages of cervical cancer. This study aimed to assess the cost-effectiveness (CE) of the primary treatment plans related to the survival rate for cervical cancer screening in the western part of Romania and provide some recommendations. Descriptive statistics and a correlation model were used to examine costs. AI models have been developed to forecast the CE of different treatments using the above-mentioned studies on overall survival rates and treatment-related toxicity rates for five years. The costs of cervical cancer treatment were sourced from the public health department, the oncology clinic in the western region of Romania, and the County Hospital available for each stage. Treatment expenses vary by cancer stage, with a significant increase from stages IA/IB to IIA, stabilizing between IIA and IIIC (about €7800-€8300), followed by a steep decline in IVA and a more pronounced decrease in IVB and in situ. The results highlight certain treatment combinations and their costs, indicating that the highest costs (exceeding €8000) are linked to multimodal treatments, which encompass surgery, chemotherapy, radiotherapy, and brachytherapy. : Advanced cancer stages (IIA-IIIC) entail the highest treatment costs due to intricate, multimodal therapy, whereas early stages (IA, IB, in situ) and late terminal stages (IVB) are linked to considerably reduced treatment costs.

摘要

作为欧洲宫颈癌发病率和死亡率方面的主要国家,罗马尼亚迫切需要提升其宫颈癌管理水平。国际妇产科联合会设定的标准表明,在宫颈癌的各个不同阶段,不同治疗方法在无进展生存期和总生存期方面应具有相似趋势。本研究旨在评估罗马尼亚西部与宫颈癌筛查生存率相关的主要治疗方案的成本效益(CE),并提供一些建议。使用描述性统计和相关模型来审查成本。利用上述关于五年总生存率和治疗相关毒性率的研究,开发了人工智能模型来预测不同治疗方法的成本效益。宫颈癌治疗成本来自罗马尼亚西部地区的公共卫生部门、肿瘤诊所和各阶段可用的县医院。治疗费用因癌症阶段而异,从IA/IB期到IIA期显著增加,在IIA期和IIIC期之间稳定(约7800 - 8300欧元),随后在IVA期急剧下降,在IVB期和原位癌期下降更为明显。结果突出了某些治疗组合及其成本,表明最高成本(超过8000欧元)与多模式治疗相关,多模式治疗包括手术、化疗、放疗和近距离放疗。:晚期癌症阶段(IIA - IIIC)由于复杂的多模式治疗而导致最高的治疗成本,而早期阶段(IA、IB、原位癌)和晚期终末期(IVB)的治疗成本则大幅降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ccc/12191868/8ed8f24aee25/curroncol-32-00336-g001.jpg

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